Online Application for TPM Awards

Deadline for applications is 29th January 2010.

For late applications please contact Tomomi Austin-Bailey on 0121 717 6619.

Guidance Notes

Please complete the form below with all relevant details
When you click on the 'Submit' button your application will automatically be submitted to your assessment agency.
Additionally,a printed copy of your application form will be produced. This should be signed by the company TPM official and sent by courier to your assessmemt agency
When we receive both online application and posted application we will acknowledge by email receipt of these submissions. If acknowledgement is not received within 3 days please contact us.

	Company Information
	1.1	Company name:
	1.2	Company Plant Name (if different):
	1.3	Address of Plant:
		Address line 1:
		Address line 2:
		City:
		Postcode:
		Country:

	People Information
	2.1	Plant Senior Manager (Plant Manager, MD, CEO) Given Name:
		Family Name:
		Title:
		Contact Telephone:
		Email Address:
	2.2	Plant Contact for TPM (Normal contact person for TPM matters) Given Name:
		Family Name:
		Title:
		Contact Telephone:
		FAX No:
		Email Address:
	2.3	Finance Contact (To whom invoices and other finance matters may be addressed) Given Name:
		Family Name:
		Title:
		Contact Telephone:
		Email Address:

Awards Category
Please select one from the list
	Award for TPM Excellence, Category A	Special Award for TPM Achievement
	Award for TPM Excellence, Category B	Advanced Special Award for TPM Achievement
	Award for Excellence in Consistent TPM Commitment	Award for World-class TPM Achievement

	Additional Plant Information
	4.1	Product Range:
	4.2	Annual Turnover (State Currency):
	4.3	Number of Employees:
	4.4	Total Size of Site (m2):
	4.5	Number of days required to complete the assessment:

Consultant(s)
The name of your regular consultant and also the name(s) of any other person(s) performing consulting services such as one day consulting, special visit and Health check are requested
	Name of Consultant	Name of the Consulting Firm




This is required to avoid any risk of a conflict of interest between a consultant and that same person being appointed as an assessor.

	Local Information
	6.1	Nearest Airport Name:
	6.2	Travelling time from Airport to Plant:
	6.3	Suggested Hotel where assessors may stay: Name:
		Address:
		Hotel Contact Telephone:
		Hotel Fax Number:
	6.4	Travelling time from Airport to Hotel:
	6.5	Travelling time from Hotel to Plant:

TPM Information
7.1	Do you already have a TPM Award?	YES NO
7.2	If YES, Category of Award:
7.3	Year of Award

	Serious Accidents
	Have you had any serious accidents in the last 12 months? If YES, Accident Report must be attached	(Please tick appropriate box) YES NO

	Signature
	Please Note: An original application form will automatically be printed when the above form is submitted. The form MUST be signed and submitted by courier to the address below in time to meet the deadline. By signing this form you are entering into an agreement between the TPM Applicant for 2010 as stated herewithin and Assessment Agency. This agreement is valid from the date of the application and until all maters between the TPM Applicant for 2010 and Assessment Agency relating to the 2010 TPM Awards are closed.
	Signature		Date
	Please print name
	Title

	Contact Details
		TPM Office SMMT Industry Forum 2410 Regents Court, The Crescent, Birmingham Business Park Birmingham B37 7YE, United Kingdom TEL: +44 (0) 121 717 6600 FAX: +44 (0) 121 717 6699
	TPM Contact:	Tomomi Austin-Bailey (Mrs)
	E-mail:	tpmoffice@industryforum.co.uk
	Telephone:	+44 (0)121 717 6619

First Stage Assessment Preferred Dates

8.1

For First Stage Assessment please indicate your preferred weeks
(Please mark 5 weeks in order of preference)