Submit eight (8) copies of the application no later than December 15, 2006, along with the appropriate fees.

Instructions

Applicants will use the specific set of criteria for their organization: Business, Education, or Health Care from the Baldrige National Quality Award program. The criteria are located at: .

Applicants should read all information in the Criteria for Performance Excellence prior to writing the application.

  1. Complete the Application Form. Enter name and address of the applicant organization.
  1. Select the most appropriate business category: Manufacturing, Education, Service, Health Care, or Public Sector.
  1. Indicate the criteria used in preparing the application: Business, Education, or Health Care.
  1. Provide the name and contact information of the individual who will be answering questions and cooperating with the lead examiner in site visit arrangements.
  1. Site visits will be scheduled as soon as possible. Provide dates preferred for the visit that cover two (2) days.
  1. Obtain the signature of the highest-ranking official on the Application Form.
  1. Begin the application by completing the Organizational Profile. Respond to each of the criteria and answer all questions. There is a maximum of 50 pages for the application. The Organizational Profile is limited to five (5) pages. Organizational charts do not count in the five (5) pages. The criteria contain items and areas to be addressed in the application. Applicants should prepare responses for all of the item requirements and areas to be addressed.
  1. Prepare eight (8) copies of the final application for mailing. Include the appropriate application fees. Attach the Intent to Apply Form and the Application Form to each copy of the final application. These forms do not count as the 50 pages for the application.

Requirements for the Application

  1. The application must be on 8!/2 x 11 paper.
  1. Use 10 point type or larger throughout the application. Charts and graphs must be readable.
  1. Submit eight (8) copies.
  1. Attach a copy of the signed Eligibility Determination Form, including the organizational chart and the Application Form to each copy of the application.
  1. Provide a glossary of terms and abbreviations defining words that may be unfamiliar to those outside your industry. (These pages do not count against the total 50 pages.)
  1. Limit the organizational profile to five (5) pages. (These pages do not count against the total 50 pages.)
  1. Number the pages of the Organizational Profile using I, ii, iii, iv, v.
  1. Number the pages of the Application from 1 to 50.
  1. Include the title of each Category and Item Number for each criteria.

Fees

Application fees are assessed according to the number of employees working for the Nebraska-based organization. These fees must accompany the application. If the application contains insufficient information for evaluation purposes, the application fees will be refunded.

Employees /

Fees

0-99 / $200
100-300 / $525
301-500 / $750
501-800 / $1,200
801+ / $1,500

2006 Application Form

The Edgerton Quality Award

NOTE: This form uses text fields (), check boxes () and drop down boxes
(Mr.Mrs.Ms.Dr.). Use your TAB key to move from one field to the next. To mark a check box, point and click with your mouse, or tab to the box of your choice and type an “x”. To remove the “x”, click the box or type “x” again. To select the appropriate name within the drop down boxes, click on the arrow located to the right of the box. Click on the appropriate item and press tab to move to the next item.
  1. Applicant
Name: (fields will expand as you type)
Address:
  1. Business Category (check one)
Manufacturing Service
Education Health Care
Public Sector
  1. Criteria Used. (check one)
Business Health Care
Education
  1. Official Inquiry Point
Name: Mr.Mrs.Ms.Dr.
Title:
Applicant Name:
Address:
Telephone #:
  1. Mail Application.
Mail the completed application with appropriate fees to: The Edgerton Award, Nebraska Department of Economic Development, P.O. Box 94666, Lincoln, NE 68509-4666.
Make checks or money order payable to:
Nebraska Department of Economic Development.
(Other forms of payment are not accepted.) /
  1. Site Visit Schedule.
A site visit (if scheduled) will take place between February 1–15. The examiners’ site visit may cover two (2) days. List preferred dates for the site visit.
7. Release Statement
We understand that examiners for The Edgerton Award will review this application. Should our organization be selected for a site visit, we agree to host the site visit and facilitate an open and unbiased examination.
If our organization is selected to receive an Award, we agree to share information on our successful performance and quality strategies with other Nebraska organizations.
I state and attest that: 1) I have reviewed the information provided by my organization in this application and 2) to the best of my knowledge, no untrue statement of material fact is contained and no omission of a material fact that I am legally permitted to disclose and that affects my organization’s ethical and legal practices has been made. This includes, but is not limited to, sanctions and ethical breaches.
Signature, Highest-Ranking Official
Date:
X______
Name:
Title:
Applicant Name:
Address:
Telephone #: