APPLICATION APPLICATION FORM Please complete all details COMPANY DETAILS Name of Applicant Trading Name of Applicant Company Registration Number Contact Number Email Address of Applicant CONTACT PERSON Contact Person Name Contact Person Email Contact Person Designation Contact Person Tel PRODUCT CERTIFICATION DETAILS Specifications/Standards applied for: (VIEW FULL LIST HERE) Number of manufacturing plants 1 2 3 4 5 Address of manufacturing plants Description of internal laboratory capability Product Description Proposed Audit Date DECLARATION OF COMPLIANCE I confirm that the information supplied in this application form is correct, to the best of my knowledge, at the time of submission; and that I am duly authorised by the company to make this application The domicilium et citandi for the applicant is: Name Designation Date Should the address listed above change the applicant will inform CI within 14 days. SUBMIT
