SFQC
SCOTTISH QUALITY WILD VENISON ASSURANCE SCHEME
GROUP MEMBERSHIP APPLICATION FORM
The undernoted wishes to apply for registration under the SFQC Certification Scheme operated on behalf of Scottish Quality Wild Venison (SQWV). /

Are you a member of any other Farm Assurance Scheme(s)? If so, please advise your membership number:-

QMS
C & S / OTHER

APPLICATION FOR GROUP MEMBERSHIP

GROUP NAME

Estate/Farmer Please advise number of carcases sold per annum:- _____

Processor/Game Dealer

Correspondence Details: (please input the name and address you wish scheme documentation to be sent to)
Company Name: / Contact Name:
Address & Postcode:
Tel. No: / Fax No:
E-mail address:

Additional Sites: (if applicable)

(including details of Estate addresses and/orLead Stalker contact details, if different from the above details)

Address 1:
Contact Name: / Contact Tel Nos::
Address 2
Contact Name: / Contact Tel Nos:

MEMBERSHIP FEE:

Please tick appropriate box and enclose payment with this form. (Producer membership covers an annual membershipfee and 1 assessment fee). Cheques should be made payable to SQWV Ltd.

Any subsequent assessment fees for additional sites will be invoiced to your Company prior to assessment.

Producer

Number of carcases sold per year:

1 - 25 £40 + VAT =£50.00

26 – 50 £59 + VAT =£70.80

51 – 100 £79 + VAT =£94.80
101 – 200 £191 + VAT = £229.20
201 – 500 £228 + VAT = £273.60
501 – 1000 £268 + VAT = £321.60
1001 + £292 + VAT= £351.60

ADDITIONAL INFORMATION (relevant to application):

It is a condition of the Scheme that all applicants must sign the following declaration that they will abide by the terms of the Scheme.

DECLARATION

I (the undersigned) have read the requirements which pertain to the SFQC Certification Scheme operated on behalf of SQWV. I am fully responsible for the operation of the business at the site(s) declared and I hereby wish to apply to join the SQWVscheme.

If accepted, I agree to abide by the conditions of membership as detailed in the SFQC Scheme Regulations and SQWV scheme standards.

I declare that I KNOW/DO NOT KNOW (please delete as appropriate) of any past (within the last 5 years)/pending/current prosecutions relating to my business at time of applying for membership of the scheme. Details of prosecutions within the last 5 years must be given below:

…………………………………………………………………………………………………………………………………….

I agree to abide by the terms of the scheme and undertake to inform SFQC immediately if, for whatever reason, the requirements of the scheme can no longer be conformed to.

I understand and agree that as a member of the SQWV Assurance Scheme my membership details will be circulated to Processor members and may be listed on the SQWV website or circulated to other relevant parties.

I agree to the site(s) listed above being assessed by a SFQC assessor appointed to the scheme.

I declare that the information given on this form is correct.

Signature: / Print Name:
Position: / Date:

Application form should be returned to SQWV Scheme Manager, SFQC, Royal Highland Centre, 10th Avenue, Ingliston, Edinburgh, EH28 8NF. Tel. 0131 335 6603, Fax. 0131 335 6601.

SQWV Group Application form Issue 1, 06/2013