APPLICATION - National Laundry Group

Company Name *

Trading Name (If Different)

Correspondence Address *

Registered Office Address (If Different)

Please Select *

Company Registration Number *

VAT Registration Number *

Please give the names of Partners/Owners/Directors

Please indicate which of the following Accreditations you have achieved

ISO 9001

Date Achieved

Accreditation Body

Certificate Number

If you do not have this Accreditation please indicate whether you intend to apply, and if so give a target date

Date

If you do not intend having this Accreditation please give a reason

ISO 14001

Date Achieved

Accreditation Body

Certificate Number

If you do not have this Accreditation please indicate whether you intend to apply, and if so give a target date

Date

If you do not intend having this Accreditation please give a reason

ISO 18001

Date Achieved

Accreditation Body

Certificate Number

If you do not have this Accreditation please indicate whether you intend to apply, and if so give a target date

Date

If you do not intend having this Accreditation please give a reason

INVESTORS IN PEOPLE (IIP)

Date Achieved

Accreditation Body

Certificate Number

If you do not have this Accreditation please indicate whether you intend to apply, and if so give a target date

Date

If you do not intend having this Accreditation please give a reason

BS EN 14065

Date Achieved

Accreditation Body

Certificate Number

If you do not have this Accreditation please indicate whether you intend to apply, and if so give a target date

Date

If you do not intend having this Accreditation please give a reason

Other Accreditations held please give details below

Turnover History: Last 5 years (year one being the last complete financial year)

Year 1 *

GBP

Year 2 *

GBP

Year 3 *

GBP

Year 4 *

GBP

Year 5 *

GBP

Notes

Please answer the following questions and attach the relevant documentation as listed below.

Do you have a written Health & Safety Policy *YesNo

Health & Safety Policy (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Have you produced a COSSH Manual? *YesNo

COSSH Manual (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Do you carry you Risk Assessments? *YesNo

Risk Assessment Index (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Do you have formal Training Records? *YesNo

Training Records (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Please supply an example copy of your Policy and Procedure / Safe System of Work / Operating Procedure for a Calendar, Feeder and Folder. (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed)

Do you have formal Documented Cleaning Schedules? *YesNo

Cleaning Schedules (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Do you have formal documented Planned Preventative Maintenance Schedules? *YesNo

Planned Preventative Maintenance Schedules (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Do you have trained first aiders? *YesNo

Do you have a formal system for reporting accidents? *YesNo

Do you offer Occupational Health to your employees? *YesNo

If yes, who is your service provider? Please give details: *

Do you have an Equal Opportunity Statement? *YesNo

Equal Opportunity Statement (PDF, JPG, JPEG, PNG, DOCX, DOC only allowed) *

No file chosen

Do you have an Environmental Policy? *YesNo

Environmental Policy *

No file chosen

RENEWAL DATE *

Do you carry out Formal Induction Training?YesNo

Do you have any IOSH (Health and Safety) Certified Personnel?YesNo

Number of Certified Personnel - Working Safely

Number of Certified Personnel - Managing Safely

Have any personnel attended the TSA Code of Practice for the Safe Operation of a CTW (if applicable)?YesNo

Do you have a formal documented Pest Control System?YesNo

Please supply a copy of your Pressure Systems Regulations Contract

No file chosen

RENEWAL DATE

Please supply a copy of your Goods Vehicle Operator License (if applicable)

No file chosen

RENEWAL DATE

Do you carry out annual Portable Applicance Testing (PAT)? *YesNo

Portable Applicance Testing (PAT) *

No file chosen

RENEWAL DATE *

Have you had an Electrical Periodic Inspection for the entire laundry?YesNo

RENEWAL DATE

Please state the value of your public liability insurance *

GBP

Please state the value of your employee liability insurance *

GBP

Please state the value of your product liability insurance *

GBP

Please provide copies of the above insurance documents *

Services Offered ‐ Market Sector

Please detail percentage Turnover in each of the following Market Sectors

Hospitality (% Turnover)

Military/Emergency Services (% Turnover)

Healthcare (% Turnover)

Industrial Work Wear/Washroom Services/Dust Control Mats (% Turnover)

Other (% Turnover)

Please briefly indicate the geographical areas currently serviced (e.g. By County-Oxfordshire, By Region-East Angliam, By Radius‐S.W.100 Miles etc.) *

MEMBER APPLICATION