Needs Assessment Questionnaire
Fill in the questionnaire below for a certification quote.
Company Name
*
Name
*
First Name
Last Name
Email
*
[email protected]
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Facility Type (select most appropriate)
*
Manufacturing Facility
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 in special instructions)
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
*
Domestic
UK/Europe
Indonesia
Malaysia
Singapore
UAE
Egypt
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+
How did you hear about us?
Google Search
Social Media (Facebook, Instagram, etc.)
Referred by a Friend
Online Advertisement
Other
Special Instructions
Submit
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