Application form for Social & Labor Convergence Program (SLCP)

SLCP.APP.F01(05)

With this form a licensee can request Control Union Certifications for additional services such as applications for Import Authorizations for importers. Please fill out one form per address.

General Information
NAME OF COMPANY APPLYING AND LEGAL STATUS
(Please use full name of company with e.g. Ltd., Inc, SAC, SA, SARL, BV)
ADDRESS OF COMPANY
(Street, post code, town, province, country, P.O. Box)
(Please note: country is mandatory) ADDRESS OF COMPANY
(Street, post code, town, province, country, P.O. Box)
(Please note: country is mandatory)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
COMPANY FASCILITY NUMBER
(Registration number in SLCP Gateway)
COMPANY’S LEGAL REPRESENTATIVE
(Name of person and function)
COMPANY’S CONTACT PERSON
(Complete if different from Legal Representative)
CONTACT NUMBER
EMAIL
WEBSITE
Verification Module (Please check with your BRAND)

Verification Module (Please check with your BRAND) Step 1 (Recruitment & Hiring, Working Hours, Wages & Benefits, Worker Treatment, Worker Involvement, Health & Safety, Termination) Step 2 (Step 1 + Management System) Step 3 (Step 1 + Step 2 + Above & Beyond)
Verification Type

Verification Type Initial Verification Periodic Verification
Type of Announcement

Type of Announcement Announced Semi-Announced
Accredited Host

Accredited Host FFC Higg
Assessment Version

Assessment Version CAF 1.5
Assessment ID (PRJ)
Does the BRAND ordering this verification nominate any particular verification body?

Does the BRAND ordering this verification nominate any particular verification body? YES (If yes, please verify that your buyer will accept the verification by Control Union) NO
Indicate the buyer(s) you are supplying
Name of the buyer
Was the audit ordered by the brand?

Was the audit ordered by the brand? Yes No
Remarks (If any)
Is there a particular date by which your SLCP Verification needs to take place?

Is there a particular date by which your SLCP Verification needs to take place? NO YES
If Yes, the audit should take place before If Yes, the audit should take place before / MM / DD YYYY
1. Scope of registration:
Describe below your business activity to be audited:
2. Site/s details
Site name, Site address, Site reference, Details of the process
3. Site locations
Please describe the location of the sites
E.g. travel time between the different sites, if applicable estimated time needed for traveling from nearest international airport, etc
4. Facility inspections
Has the facility to be inspected ever been registered, inspected or certified for social/labor compliance before by another Inspection/Certification Body?

Has the facility to be inspected ever been registered, inspected or certified for social/labor compliance before by another Inspection/Certification Body? Yes No
If YES, please share: the name of the inspection and/or certification body, year of application, reason for changing inspection/certification body. Please enclose copies of the relevant documents concerning the previous inspection(s) (SMETA Report, SMETA CAPR, etc.).
Does the facility participate in other certification programs (safety; environmental; sustainability; etc.)?

Does the facility participate in other certification programs (safety; environmental; sustainability; etc.)? Yes No
If YES, please share:
5. Worker Analysis
Please mention the TOTAL number of workers (Include both MALE & FEMALE workers. Include all LOCAL & MIGRANT workers. Include all PERMANENT, TEMPORARY & AGENCY workers)

Number of workers shall be excluding the management, staff and supervisors. only the employees where no one reports to them. If you have multiple sites, please indicate details against each site separately
Worker analysis

If you have multiple sites, please use the below format to upload the details.
Eg: Site 01
Worker analysis details for multiple sites

Attach Files

Upload your worker analysis details if you have multiple site locations
Eg: Site 01, Site 02, ......
Please indicate your peak production season, if any:
Please indicate your working hour system (Include all shifts)
Is there a Union, Collective Bargaining Agreement, or other worker welfare group in place at the site?

Is there a Union, Collective Bargaining Agreement, or other worker welfare group in place at the site? Yes No
If yes, please explain:
Migrant Workers
Originating Locations/Countries:
Work performed by migrant workers:
Were migrant workers recruited through an agency?
If YES, please provide contact information for each agency providing migrant workers
Is there a contract with the agency providing migrant workers?
If YES, please share contractual details
Percentage of migrant workers in company who are provided housing accommodation:
6. Subcontractors:
Do you make use of any subcontractors to produce goods/services at this facility?
If yes, please share each subcontractor’s name and address; and the activity it performs for this facility.
7. Please list the languages spoken by workers at the facility.
Language spoken by workers & Number of workers speaking this language
8. Details of Accommodation / Housing provided to workers
Do you provide onsite accommodation for workers

Do you provide onsite accommodation for workers Yes No
Do you provide offsite accommodation for workers

Do you provide offsite accommodation for workers Yes No
Please provide the details of the accommodation provided for workers (including Migrant workers). Both onsite and offsite locations with their address, Distance from the facility and number of workers at each place
I, the undersigned, declare that this application form has been completed truthfully
NAME OF COMPANY
LEGAL REPRESENTATIVE
FUNCTION WITHIN COMPANY
Date Date / MM / DD YYYY
SIGNATURE

Draw or Type

Clear

Full Name

Application form for Social & Labor Convergence Program (SLCP)

Application form for Social & Labor Convergence Program (SLCP)

General Information

Indicate the buyer(s) you are supplying

1. Scope of registration:

2. Site/s details

3. Site locations

4. Facility inspections

5. Worker Analysis

Worker analysis

Migrant Workers

6. Subcontractors:

7. Please list the languages spoken by workers at the facility.

8. Details of Accommodation / Housing provided to workers