RECOGNISED FOR excellence

APPLICATION FORM
company details
Name
EFQM Member
(if you are not an EFQM Member, please contact us for more information about Membership) / Yes / No
Sector / Public / Private
Number of employees / Number of locations
Address / Postcode
Tel / Fax
Preferred date for site-visit: ……………………………………………………………………………………………………
Concise description of the business activity (products, customers, markets… Max. 50 words)

personal CONTACT details
Name / Title
Tel / Email / Fax
APPLICATION fee*
Europe
  • EFQM Member between 7,000 and 11,000 Euro excluding VAT (21%)**
  • Non-member between 10,000 and 15, 714 Euro excluding VAT (21%)**
Outside Europe
  • EFQM Member between 9,000 and 14,000 Euro excluding VAT (21%)**
  • Non-member between 12,857 and 20,000 Euro excluding VAT (21%)**

*In addition to the application fee, the organisation applying bears the travel & accommodation costs associated to the site visit
** Price calculation based on size and complexity of organisation
payment details
Postal Address
Invoice Address (If different from Postal Address)
Purchase Order Number (if needed)
VAT Number
CONFIRMATION
Efqm Cancelation Policy
If you have to cancel your application, please advise us in writing at least 30 working days before the start of the site-visit. Thereafter a cancellation charge of 50% is applicable. In case the assessors or EFQM have already incurred in any cost, you will need to cover these costs (to assessors directly and to EFQM).
You may postpone your application one time only, but we require 30 working days’ notice. If you cannot meet this notice period (you cancel 29 working days or less before the start of the site-visit), we will apply the cancellation policy (50% of the total fee).
If you cancel too late but wish to postpone the application, we will charge you only 40% of the total fee.
Name / Job Title / Place / Date / Signature
WHO RECCOMENDED THAT YOU APPLY?
Name: / Organisation:

Avenue des Olympiades 2,B-1140 Evere

T +32 2 775 35 11 Please return this Application Form to