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G Pea Eligibility Form 2017

This document is an eligibility certification form for the 2017 Global Performance Excellence Award (GPEA). It requests information about the applicant organization, including name, address, size, previous awards received. It outlines the award categories and submission requirements, including submitting copies of the national quality award application and feedback report. It details the payment process and amounts due to be considered for the GPEA, and requires signature of the highest ranking officer to certify eligibility and agree to the judges' decision.

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Lara Gutierrez
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76 views4 pages

G Pea Eligibility Form 2017

This document is an eligibility certification form for the 2017 Global Performance Excellence Award (GPEA). It requests information about the applicant organization, including name, address, size, previous awards received. It outlines the award categories and submission requirements, including submitting copies of the national quality award application and feedback report. It details the payment process and amounts due to be considered for the GPEA, and requires signature of the highest ranking officer to certify eligibility and agree to the judges' decision.

Uploaded by

Lara Gutierrez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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ASIA PACIFIC QUALITY ORGANIZATION

Global Performance Excellence Award (GPEA)


2017 Eligibility Certification Form

1. Applicant
Official Organization Name
(NAME THAT WILL APPEAR IN THE CERTIFICATE, PLAQUE AND ALL COMMUNICATION MATERIALS)

Other Name:
Prior Name:
Headquarters Address:

Website:

2. Highest Ranking Officer (CEO) Mr. Mrs. Ms. Dr.


Name:
Job Title:
Address:

Telephone:
Fax No.:
E-mail:

3. Eligibility Contact Point Mr. Mrs. Ms. Dr.


Name:
Job Title:
Address:

Telephone:
Fax No.:
E-mail:

4. Alternate Eligibility Contact Point Mr. Mrs. Ms. Dr.


Name:
Job Title:
Address:

Telephone:
Fax No.:
E-mail:

Note: Winners of the GPEA must personally accept the award at the conference ceremony.

1
5. Optional Feedback Report
(IF NO BOX IS CHECKED, THEN NO FEEDBACK REPORT WILL BE PROVIDED AND THIS CANNOT BE CHANGED IN THE
MIDDLE OF THE EXAMINATION PROCESS)

Our organization desires a feedback report YES NO


PLEASE SEE BELOW (10. Payment Procedures) THE ADDITIONAL $750 FOR THE OPTIONAL FEEDBACK REPORT

6. Award Category (CHECK APPLICABLE BOX)

Small Manufacturing Organization (less than 250) Large Manufacturing organization

Small Service Organization (less than 250) Large Service Organization

Educational Organization Not for Profit organization including


Government Organization
Health Care Organization

7. Type of Application to be submitted


(PLEASE IDENTIFY WHICH FORMAT YOUR AWARD APPLICATION IS MOST MODELED TO OR ORIGINATED FROM)
Baldrige Type format European Type format

8. Size and Location of Applicant


a. Total number of:
• Employees business)
• Faculties / Staffs (educational)
• Staffs (health care)
b. Preceding fiscal year:
• Check one financial descriptor: Sales Revenue Budget
• Check amount: (In US Dollars) 0-$1M $1M-$10M $10M-$100M
$100M-$500M $500M-$1B Over $1B
c. Number of sites in: Home Country / Territories Overseas
d. Percent employees in: Home Country / Territories Overseas
e. Percent physical assets in: Home Country / Territories Overseas
f. Attach a line and box organization chart for the applying organization, including the name of
the head of each major unit of division.
9. Information on your successful national award: (2015 – 2016)
Name of National Award:
Date your successful award announced Day Month year
Date your successful award received Day Month year
Name of country issuing the award:
Name of organization(s) and/or governmental agency(ies) sponsoring the award:

Name and address of organization(s) that assess, evaluate and select the award:

Category(ies) that your award qualifies in:

2
Name(s) of all other national winner(s) in this/these category(ies), if any (list all)

The National Quality Award Organization or the candidate must include in its NQA and feedback / site visit
report that the GPEA application documents reflects the organization’s actual operations. Please furnish
dates of site visit(s) by the organizers of your national award and provide support documentation
(preferably a letter from the organizer). Locations and Dates Visited.

The National Quality Award Organization must recommend the organization as a candidate for the Global
Performance Excellence Award. Please attach appropriate documentation to meet this requirement. This
correspondence must be specifically addressed to Global Performance Excellence Award Committee, It
must recommend your organization and it must be signed by a current officer of the National Quality
Award Organization.
Attach a copy of award certificate, citation or news release documenting your award.

Visit: www.baldrige.com / www.efqm.org for criteria


10. Submission of Documents: (To Dr. Charles A. Aubrey II and APQO Executive Office)
a. All materials must be in English. Please submit four (4) complete copies of Baldrige application, four
(4) complete copies of National Quality Award (NQA) Feedback / Site visit report, one (1) copy of the
evidence as a National Quality Award Winner, one (1) copy of GPEA application and Eligibility
Certification Form and all supporting materials / documents to:

DR. CHARLES A. AUBREY II


AubreyPartners
10186 Evergreen Drive, Grand Junction, MI 49056
U. S. A.
NOTE: For electronically sent documents, only “Word” or “PDF” files will be acceptable for
sending Eligibility Forms, GPEA Applications and National Feedback Reports.
b. Send a soft copy of your Filled up GPEA Eligibility Certification Form to the APQO Executive Office
at: executive@apqo.org and admin@apqo.org .

11. Payment Procedures:


a. Mail your check in USD, 2,250.00 for APQO member country and USD 2,500.00 for APQO non-
member country (registered mail to avoid tax charges) to the Asia Pacific Quality Organization
(APQO) Executive Office.
b. Feedback Report – USD 750.00 (optional)
APQO Executive Office Address: VICTORIA M. VALLESTERO
Asia Pacific Quality Organization
No. 45 Hybrid Street., Phase VI
Greenwoods Executive Village
Cainta, Rizal 1900, Philippines

OR
c. Deposit the amount (kindly consider the bank tax charges from your country and the USD 6.50 Bank
of the Philippine Islands bank tax charges so we can receive the full amount of payment) and write
the following:
Name of Payee: ASIA PACIFIC QUALITY ORGANIZATION
3
Name of Payer: (Name of organization / company representative)
Bank Name: Bank of the Philippine Islands
Bank Address: 0807-Ortigas St. Francis Square Branch, G/F, St. Francis Square,
Julia Vargas cor. Bank Drive, Mandaluyong City, Philippines
Dollar Savings Account No.: 8074-0002-91
Swift Code: BOPIPHMM
NOTE:
For reference and information on your payment, please send a copy of the bank wire transfer form /
application through e-mail at: admin@apqo.org
The Global Performance Excellence Award is based on the U.S. Malcolm Baldrige National Quality Award
(MBNQA) or European Foundation for Quality Management (EFQM). All applicants must submit their
application form along with the feedback / site visit report addressing all criteria items according to the
MBNQA requirements. Application forms are available and can be downloaded from our website:
www.apqo.org

If your National Award uses the MBNQA format, copies, in English, of your original award application will
suffice.
Additional supporting / Required Materials:
• Copy of your application for your National Quality Award (in English).
• Completed Malcolm Baldrige National Quality Award Application. Note: Not required if your
national award is based on MBNQA. Applications can be no longer than 60 pages maximum with
no additional documents. (Please note that any extra pages and documents submitted over the 60
page limit will be removed from the evaluation)
• Current Organizational Description (See MBNQA current Criteria for Performance Excellence
requirements). (Limit 5 pages). (OPTIONAL).
• Current Organizational Challenges (See MBNQA current Criteria for Performance Excellence
requirements). (Limit 5 pages). (OPTIONAL).
NOTE:
For electronically sent documents, only "Word" or "PDF" files will be acceptable for sending Eligibility Forms,
GPEA Applications and National Feedback Reports
12. Self-Certification statement, Signature – Highest Ranking Officer
I certify that the answers provided are accurate and that my organization is eligible based on the current
requirements for the Malcolm Baldrige National Quality Award, I understand that any time during the
Award Process cycle, if the information provided was inaccurate, my organization will no longer be eligible
for the award.
We agree that the determination of the GPEA Judges is final and we agree to abide by their
decision as the rules do not allow any process to change this final decision.

Printed Name:
Date: Day Month year

Signature:

or insert electronic signature above

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