Application for 2008 TPM Award

Filing date: ______

Reference #.CSD______

Applicant

Company Name / English
Chinese
Factory/Plant Name / English
Chinese
Representative name / English / Chinese
Name / English / Chinese
Title: / English / Chinese
Permanent Address of Applying Plant

Contact Person

Contact Person / English
Chinese
Title: / English / Chinese
Mailing Address
E-mail
TEL / FAX

Billing Contact

Contact Person / English
Chinese
Mailing Address
E-mail
TEL / FAX

Desired (Applied) Awards Category (Chose one from below and delete others):

1)  Award for TPM Excellence, Category B

2)  Award for TPM Excellence, Category A

3)  Award for Excellence in Consistent TPM Commitment

4)  Special Award for TPM Achievement

5)  Advanced Special Award for TPM Achievement

6)  Award for World-class TPM Achievement

Analysis/Description of the Plant

Number of Employees: / Number of Plants Consist :
Number of day need to complete an assessment: / ( )day(s) / Main Product:

Name of Consultant(s)

Not only the name of your regular consultant, but also of the person who performed consulting services, such as one day consulting, special visit, and Health Check are required.

Name / Name of consulting firm

*this is required in order to avoid any possible occasion that consultants having close relationship with applicants visit the same applicants as an assessor.

Locations

Traveling time from the nearest airport to designated Hotel.

Name / Time Required
#1
#2

1)  Traveling time from the accommodation where the Assessors will stay

Name of Hotel
Address
TEL
FAX
Time Required from the factory/plant

Holidays and Plant Close in the Assessment Period

Date 日期

Serious Accident in Past 12 Months

None / Yes (Accident Report must be attached)
Latest TPM Award: / No / Yes
Awarded Year
Category
Awarded Company Name (If changed)

Preference week for the First Assessment (Please indicate your 1st to 5th choice)

Week / Your choice / Week / Your choice / Week / Your choice
14 / 3.31～4.4 / 19 / 5.5～9 / 24 / 6.9～13
15 / 4.7～11 / 20 / 5.12～16 / 25 / 6.16～20
16 / 4.14～18 / 21 / 5.19～23 / 26 / 6.23～27
17 / 4.21～25 / 22 / 5.26～30 / 27 / 6.30～7.4
18 / 4.28～5.2 / 23 / 6.2～6 / 28 / 7.7～11

Signature： Date：

Name in Print and Title

*An Original copy of the application with authentic signature must be submitted by mail in time to meet the deadline. Please also send by e-mail to meet the deadline just before you send mail, so that it will be confirmed in advance.

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