TQM Award SAMPOORN Registration and Eligibility Determination Form

1. Business Entity Name :*

2. Site Address:*

3. Overall Organization Name (if applicable):*

4. Organization Headquarter Address (if applicable) :*

5. Highest-Ranking Official at Site Full Name ::*

Highest-Ranking Official Address*

Highest-Ranking Official Mobile No*

Highest-Ranking Official Email:*

6. Highest-Ranking Official at Headquarters:

Highest-Ranking Official at Headquarters Address

Phone Number

Email*

Mobile No

7. Applicant-Category for TQM Award – (pl tick as appropriate):*

Business Excellence (Manufacturing (For Profit only) / Service (For-Profit only) / IndianOverseas Business (For-Profit Only)

Education

Health Care

NGOs / Others

8. Size and Location of Applicant*

A - Total Number of Employees (Business): (this includes contract workforce)*

- Total Site area under administration (Sqft): *

9. Sales in the preceding fiscal year (in Crores) (pl tick as appropriate):*

0 - Rs.100 Cr

Rs.100 Cr - Rs 1000 C

1000 Cr.- Rs.10000 Cr

More than Rs.10000 Cr

11. Please find attached is brief organization-introduction giving brief details of products,processes, Supply Chain, markets, Turnover, profits, management systems, people practices,improvement systems, certifications and awards, efforts on Safety, environment,digitalization etc. A brief insight into Growth journey of the organization need be attached(maximum 600 words / 2 pages).*

Undertaking*

12. Undertaking: I state and attest that I have reviewed the information provided by my organization in this page to the best of my knowledge. No untrue statement of a material fact is contained in this declaration, and no omission of a material fact has been made. I understand that at any time during the Award Process cycle, if the information is found not to support eligibility, my organization will no longer receive consideration for the Award. We will be driving all adaptable improvements emerging from the assessment report towards our journey to full potential.

12.1. Name of the Business Head at Site

Business Head Email

Business Head Mobile No

12.2 Name of TQM/ BE / Innovation Dept Head

TQM/ BE / Innovation Dept Head Email

TQM/ BE / Innovation Dept Head Phone Number

12.3. Name of TQM Coordinator*

TQM Coordinator Email*

TQM Coordinator Phone Number*

This field should be left blank

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