APPLICATION FOR HALAL CERTIFICATION

Please note all information is Confidential:-

Date:
Plant Name: Web:
Address:
Street Name / Suite #:
City: Province / State: Postal Code / Zip:
Phone: Fax: Toll Free:
Plant Contact: Title:
Phone: Email:
Alternate Contact: Title:
Phone: Email:
R & D Contact: Email:

1) Please indicate the closest major city/ town and the distance to the facility:
2) Please indicate the geographic areas where you plan to market the product (s):
 Canada   USA   Indonesia   Malaysia   Singapore   Qatar
  UAE   Saudi Arabia   Egypt   Kuwait

Other: 
3) Nature of Product:
4) Brand name of Product to be certified:
Describe all the manufacturing process in this plant:
Security Code: Refresh Image











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