APPLICATION FOR GLUTEN FREE CERTIFICATION

APPLICATION FOR GLUTEN FREE CERTIFICATION

ALL ABOUT GLUTEN FREE ORGANAIZATION (AAGF)17 MORRIS ROAD, SPRING VALLEY, N.Y. 10977(845) 426 – 0691, (917) 468 – 4762, Fax: (845) 426-5017EMAIL; admin@glutenfree-aagf.com
Company Information Applicant:
Name

First Name Last Name
TITLE
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Website info
Quality Control Information:
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email
example@example.com
Manufacturers Information if not the applicant
Contact Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Website info
Nature of products produced in your facility
Please provide a brief description of your facility
Are you seeking for gluten Free certification for your entire plant?

Yes No
Does the facility produce Gluten and non-gluten free products?

Yes No
Please itemize the products you are looking to be certified
Are all items produced on shared equipment?

Yes No
Provide a brief description of methods used to prevent cross-contamination.
Are you currently labeling your products as gluten free?

Yes No
Are you currently certified Gluten free?

Yes No
Who provides you the certification?
Are you currently testing produced products?

Yes No
How is it done?
please select the method of testing
How often do you perform testing?

weekly Monthly Bi-Monthly
Upon the approval of your application, you will be receiving an excel sheet prepared for your use in providing us with a list of ingredients.

PLEASE NOTE: A $200.00 non-refundable application fee must be mailed to our office at 17 Morris Rd. Spring Valley, NY 10977 in order to process this application. Checks should be made out to AAGF. Submission of this form serves as an affirmation that the answers provided are truthful to the best of your knowledge. Upon signing a contract agreement for the services of AAGF within three months of the application, the $200.00 will be deducted from your certification fee.
Please submit a sample of packaging or label used for the products you would like them to be certified. Samples shall be for every single brand name used.

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Cancel of
AAGF AGREEMENT
In filing this application with AAGF, AAGF and the Company agree to the below listed terms:
1. AAGF will keep all information in this application highly confidential and non-disclosure, except as needed to conduct business for certification.
2. The Company agrees to allow AAGF or one of its staff members for a Plant audit for the purposes of determining the ability to certify the Plant and products. The company further agrees to pay the audit fee. And travel expenses for the audit will be invoiced after the audit.
3. The Company understands that certification is not guaranteed and cannot be granted without a Plant Audit by an AAGF auditor.
4. If the Company agrees to enter a contract agreement with AAGF, 50% Certification fee will be due at the time of signing the contract. Final certification fee will be required 4 months later.
Company Representative
Type Name
Signature

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Date
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