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Needs Assessment Form
Fill in the form below for certification quotes.
Company Name
*
First Name
*
Last Name
*
Email Address
*
Contact Number
*
Street Address
City
State
Zip Code
Country
Facility Type (select most appropriate)
Manufacturing
Restaurant
Livestock Processing (Farm/Slaughterhouse)
Catering Kitchen
Grocery Store or Marketplace
Distribution Center
Other (Add to special instructions)
Product Type (select all that apply)
AC - Activated Carbon
CH - Chemicals
CS - Cosmetics
DY - Dairy
FL - Flavors
LS - Livestock
MM - Menu/Meals
NS - Non-Specific
NU - Nutraceuticals
OL - Oils
PM - Packaging Material
PH - Pharmaceuticals
PL - Plastics
PY - Poultry
PR - Produce
RM - Raw Meat
RC - Refined Consumables
Other (specify below)
Approximate Square Footage
Number of Products Sold as Halal or To Be Certified
Number of Total Unique Ingredients
Urgency (Delivery Expectation)
Standard Processing
Expedited Processing (Delivery within 10 days)
Product for Export? Select all countries that apply
US
UK
Indonesia
Malaysia
Singapore
UAE
Other (Add Country to special instructions)
Your company's size in terms of annual revenue?
$0 - $200,000
$200,001 - $500,000
$500,001 - $999,999
$1,000,000 - $4,999,999
$5,000,000+
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