AF1.1 GROWER GROUP APPLICATION FORM - NASAA

Version: 16/8/11
AF1.1 GROWER GROUP APPLICATION
FORM
Page 1 of 4
NASAA Certified Organic P/L
PO Box 768 Stirling SA 5152 TEL +61 (08) 8370 8455 FAX +61 (08) 8370 8381
EMAIL enquiries@nasaa.com.au WEB www.nasaa.com.au
A. APPLICANT DETAILS
Company Name in full…...…………….…………………………………………………………………………………………….
Trading As ……………………………………………................................................ABN................…….....................…….
Contact Person (Group Manager) ...........................................................................Position………….……………………
Postal Address …………………………………………………………………………………..……..Post Code.......................
Physical Location Address (see Section D) …………………………………........................................................................
Phone No: (……)…………………………...............................Fax No: (……)………..…………………................................
Email …………………………………………………………..………….…Mobile ……………….….............................….…..
Are you currently, or have you previously been certified by another certifier? YES NO
Have you been denied certification by another certification body? YES NO
If Yes, please provide the name of the certifying body & brief explanation……………………………………………...….
………………………………………………………………………………………………………………………………………….
B. GROWER GROUP DEFINITION
A Grower Group is defined as an organised grouping of small-scale producers with similar farming and production
systems, usually based around villages. The group certification only applies to a group as a whole that has
coordinated marketing. Special inspection arrangements have to be applied by the group management (Internal
Control System). A representative of the Internal Control System (ICS) is required to act as co-ordinator of the group
and is responsible for the group’s day-to-day compliance with organic standards and certification requirements.
Further requirements are outlined in the International Licensee Policy. The group must be functioning prior to
application being accepted.
Associated materials required for the application: NCO International Grower Group Certificatin Criteria; NASAA
Concise Standards for Grower Groups; Organic Management Plan; Organic Handling Plan; Spreadsheet for group
member data; Internal Control System Info Sheet; AI1.0 Map & Site Diagram Requirements.
C. PRODUCTS &/OR PROCESSES TO BE CERTIFIED
Select Market Programs Required (tick boxes)
NASAA IFOAM INTERNATIONAL
International only
NASAA INTERNATIONAL EU
(IFOAM)
International EU Export
Separate applications are required for US NOP, Japan JAS and Canada COR.
Current export markets: ……………………………………………………………………………………………………………
Proposed export markets: …………………………………………………………………………………………………………
List all crops, products etc to be certified:
………………………………………………………………………………………………………………………………….….....
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Version: 16/8/11
AF1.1 GROWER GROUP APPLICATION
FORM
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On farm processing: YES NO (eg coffee cherry to parchment; honey extraction; fruit drying)
If yes, you must submit an Organic Handling Plan (OHP) and a flow plan describing product movement through each
facility. The OHP form is available from NCO office or on the website.
D. GROWER GROUP & SUPPLY CHAIN ELEMENTS
1) Please complete the matrix below for ALL elements from producers to processors, packers, handlers and
exporters in your supply chain:
EXAMPLE:
Type Number/name Product/Service Location Certifier Name
Producer Grower 450 growers/ A & B Raw coffee bean 400kms north east Applied to NCO
Group
villages
of Colombo, Sri Lanka
On farm Processor A & B villages Parchment On farm, same
Applied to NCO
location
Packing factory Coffee Packers Co Packing Colombo NCO
Export
Coffee Exporters Co Export to Australia & Colombo
NCO
Japan
Factory n/a Roasting Brisbane Australia NCO
Export n/a Export Brisbane to USA NCO
Type Number/name Product/Service Location Certifier Name
2) FLOW PLAN: Provide a flow plan showing product movement through the supply chain from production sites to
export. Indicate the owner/company for each separate entity in the chain. All businesses must be listed by name.
3) MAP OF GROUP AND LOCATION:
Please attach a map covering all land to be certified. Refer to NASAA Organic Standard 2.5 and the Organic
Management Plan for details. All villages must be shown.
4) GROWER GROUP STRUCTURE & ICS
Outline how this is organised, who manages it, how geographically near to each other are the growers etc.
Please refer to the Setting up an Internal Control System Info Sheet. Please submit the group’ ICS Manual. For
assistance with developing your ICS we strongly recommend publications by IFOAM available at www.ifoam.org
/Bookstore/TrainingManual/Smallholder Group Certification – Producers, Internal Control Systems for Group
Certification – Training Kit for Producers
5) TIMELINE
Please indicate below your preferred timeline, your priorities for markets and anything else you can tell us which will
enable us to give you the best service for your requirements:
………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………….
6) ANY OTHER COMMENTS OR INFORMATION
………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………….
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E. STANDARDS & COMPLIANCE
Version: 16/8/11
AF1.1 GROWER GROUP APPLICATION
FORM
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I have read and understood the NASAA Organic Standard. YES NO
I have read and understood the Concise NASAA Standards YES NO
1. I agree to comply with the requirements of the NASAA Organic Standard/Concise NASAA Standard.
2. I agree to supply NCO with further information needed for evaluation of the production to be certified.
3. I understand that if the information I have supplied is false the application will be cancelled.
4. I consent to the use of subcontracted inspection personnel and/or laboratories as required.
5. I provide this information on the understanding that it will be used by NCO in accordance with the Privacy
Statement outlined in Section I.
Print Name:…………………………………………………………… Position:…………………………………………………
Signed ………………………………………......................................……..Date……………………………………………
Please check that following has been completed before submitting your application:
Section A: Applicant Details
Section D: Grower Group & Supply Chain Elements
Section F: Payment Details
Section C: Products &/or Processes to be Certified
Section E: Standards & Compliance
Section G: Applicant Feedback
Attached: Map of Group Locations Organic Management Plan Organic Handling Plan
Site plan for each facility to be certified Supply Chain Flow Plan ICS Manual
On receipt of application, including all attachments and inspection deposit, the application will be checked for
completeness. Once approved, an inspection will be allocated. For details on OMP requirements see NASAA Organic
Standard 2.4. Forms are available from NCO office or on the website. For any assistance, contact NCO.
The application fee can be obtained from the Fee Schedule and should be inserted into this box.
The application portion is non-refundable. A quote for inspection will be provided. This can be invoiced
separately but must be paid prior to inspection.
Please send me a hard copy of the NASAA Organic Standard (price per Fee Schedule)
(Standard is free when downloaded from NASAA/NCO website)
TOTAL AMOUNT PAYABLE $
Payment by cheque payable to NASAA Certified Organic Pty. Ltd. Or by credit card
VISA
F. PAYMENT DETAILS
MASTERCARD (please circle)
CARDHOLDER’S NAME................................................................…………………………………………………………
CARD NO..........................................................................................................EXPIRY DATE......................................
Direct payment to NASAA Certified Organic Pty Ltd account; BSB 085-458 Account No 83-272-8926
For International Transfers: BIC/Swift Code: NATAAU3303M
G. APPLICANT FEEDBACK
Please indicate how you found out about certification with NASAA Certified Organic?
MEDIA ARTICLE EVENT WORD OF MOUTH
PUBLICATION
WEBSITE
OTHER (please state) …………………………………………………………………………………………………………………………………………..
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Certification Application.doc ABN 60 101 829 163

F. MEMBERSHIP OF NASAA
Version: 16/8/11
AF1.1 GROWER GROUP APPLICATION
FORM
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Membership of NASAA is entirely separate from certification by NCO for your organic operation. If you wish to apply to become a
NASAA Member please use the NASAA Membership Form enclosed and make a separate payment to NASAA Limited.
I. PRIVACY INFORMATION
NCO is committed to handling personal information about you in accordance with the Privacy Act.
NCO may collect and hold information about you for the purposes of assessing, reviewing and making decisions about
your suitability for certification and/or membership, maintaining that certification and/or membership over time, and
providing information on services and products that NCO considers may be useful and informative. You may have
access to your personal file held by NCO. NCO will handle all such personal information confidentially and will not
divulge it to any party outside NCO without your written permission except that:
♦ Generalised information may be extracted to be used for statistical purposes without disclosing personal details
♦ NCO may release such information to those bodies to which it is accredited and other certifying organisations in
some circumstances as well as meeting any lawful obligations imposed upon it by statutory authorities
♦ NCO may publish notice of your certification (if granted) on its website and will include your general certification
details on a list, which shall be available to the public on request
♦ NCO may disclose copies of your Certificates of Registration for the current and three previous calendar years
to the general public
F:\3. QUALITY DOCUMENTS\3. Forms\1. APPLICATION PACKS\a. NASAA\Grower Group Application Pack\AF1.1 NCO Grower Group
Certification Application.doc ABN 60 101 829 163