regenagri application form - Chain of Custody

Organisation Name (Please state full legal name)
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Company's Legal Representative Name of Company's Legal Representative First Last
Position/Job Title
Email
Phone
Products

Please state:
Product category: e.g. Cotton, Coffee, Sugar Cane etc
Specify Product: E.g. Socks, Roasted Coffee, Raw Sugar etc
Standard applied for: E.g. regenagri, GRS, RCS
Processes and Units

Name and Address of Units/Facilities: Include certificate holder, trading entities and sub-contracted units
Main Process(es): E.g. ginning, roasting, refining
Total No of employees per unit: Include permanent, contracted and sub-contracted
Status: Add new of withdraw
Has your company or units of your company been denied, suspended or terminated from regenagri certification?

Has your company or units of your company been denied, suspended or terminated from regenagri certification? Yes No
If you answered Yes to the above, please provide the relevant certificate number
Have your company or units of your company been denied, suspended or terminated from any other certifications?

Have your company or units of your company been denied, suspended or terminated from any other certifications? Yes No
If you answered Yes to the above, please state which certification program, when, the certificate number (if applicable) and certification body used.