Company Name Application for QMS Registration to QMS, EMS or OHSAS (Please fill this form completely and

return to AGSI-CPL by courier, fax or e-mail)

Company Name: Standard & Accreditation applied for ( what is applicable):: ISO 9001:2008 Std. (QMS) NABCB Accreditation DAC Accreditation (Dubai Accreditation Centre) ISO 14001:2004 Std. (EMS) OHSAS 18001:2007 Std.

Scope Applied for Registratio n:

Describe briefly the operations involved in the Production or Service provision

(You may attach a flow-chart):

Details of processes outsourced, if any: Relevant Legal (Statutory & Regulatory) Obligations applicable to product or service provided:

Primary Contact PersonISO: Alternat e Contact Person ISO: LOCATIO N Office Factory Branch Site (s) ( Project)

Name:

Designation:

Proprietor
Tel.: Fax: e-mail: Designation: Tel.: Fax: e-mail: ADDRESS DEPARTMENTS / FUNCTIONS

Name:

Is the quality Management System (QMS) of your organization developed by a consultant? No If Yes Please give following details: 1) Name(s) of the Consultant(s):____________________________________________________ Form No.: F 9.31 Iss.: 01 Rev.: 06 Date: 01.01.2011

Yes

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2) Name of the Consulting organization / Agency:______________________________________ Date of Implementation of QMS Initial Audit / Re-certification audit required in (Month & Year)

(NOTE: Initial audit will be conducted in two stages. 1 st stage audit includes on/offsite Documentation Review, on-site Top Management and M.R. audits and assessment of adequacy of the system and decide on the date(s) for the stage 2 certification - audit.)

Form No.: F 9.31

Iss.: 01

Rev.: 06

Date: 01.01.2011

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Employee Details *
* Note: The planning of the audit e.g. mandays, audit scheduling are based on the details as provided in this form]

(A) No. of Employees (include all employees permanent and also temporary/contract):
Dept. Function
Top Management: Marketing/ Sales: Purchase: H.R.: Design and Development: PRODUCTION: (for manufacturing companies) OR SERVICE PROVISION: (For service industries)
Give category-wise split-up below: NO. OF CATEGORY EMPLOYEES

No. of Employees

Management/ Supervisory Operators Helpers CATEGORY NO. OF EMPLOYEES

Quality Control

Management/ Supervisory Operators/ Chemists Helpers

Servicing/ Installation/ Commissioning: (where applicable) Stores and Dispatch: (where applicable) Any other: (please specify): Any other: (please specify):

TOTAL: (B) Is your organization working in Shifts (Yes/ No): ___no_______

If yes, please give shift-wise split-up of the total no. of employees:

10

General Shift: _____ Employees =

I Shift: ______ II Shift: _____

III Shift: ____ Total

(C ) Any other information you want to provide:

Form No.: F 9.31

Iss.: 01

Rev.: 06

Date: 01.01.2011

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This Questioner filled by: Name: Signatu re: Designati on: Date:
Proprietor

Company Seal

Form No.: F 9.31

Iss.: 01

Rev.: 06

Date: 01.01.2011

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