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Global Performance Excellence Award (GPEA) –2012
Application and Eligibility Certification Form

1. APPLICANT
(Official Organization Name that will appear in the Certificate, Plaque, and all Communication Materials)
Official Organization Name:
Other Name :
Prior Name :
Headquarter's Address:
Website :

2. HIGHEST RANKING OFFICER (CEO)
Mr. Mrs. Ms. Dr.
Name : 
Title :
Address :
Telephone Number :
Fax Number :
Email Address :

3. ELIGIBILITY CONTACT POINT
Mr. Mrs. Ms. Dr.
Name : 
Title :
Address :
Telephone Number :
Fax Number :
Email Address :

4. ALTERNATE ELIGIBILITY CONTACT POINT
Name : 
Title :
Address :
Telephone Number :
Fax Number :
Email Address :
   
Note: Should you win the award, you must accept the award personally. 
 
5. OPTIONAL FEEDBACK REPORT
  (If no box is checked, then no feedback report will be provided and this
  cannot be changed in the middle of the examination process)
.
   Our organization desires a feedback report:
  YES NO

6. AWARD CATEGORY (Select as applicable)
  Small Manufacturing Organizations (less 250) Large Manufacturing Organizations
  Small Service Organizations (less than 250) Large Service Organizations
  Educational Organization

Not for Profit Organizations including bbbbbGovernment Organizations
  Health Care Organizations

 
     
7. TYPE OF APPLICATION TO BE SUBMITTED:
  (Please identify which format your award application is most closely modeled
  to or originated from)
  Baldrige Type format European Type Format
     
8. SIZE & LOCATION OF APPLICANT :
  a. Total number of:
  Employees (business) :
Faculty/Staff (education) :
  Staff (health care) :
  b. Preceding fiscal year:
  Choose one financial descriptor : Sales Revenue Budget
  Choose amount (in US Dollar):    
  c. Number of sites in : Home Country/Territories Overseas
  d. Percent employees in : Home Country/Territories Overseas
  e. Percent physical assets in :Home Country/Territories Overseas
  f.  Attach a line and box organizational chart for the applying organization, including the name of the
      head of each major unit or division.
   
9. INFORMATION ON YOUR SUCCESSFUL NATIONAL AWARD (2010 - 2011) :
  Name of National/Regional Award :
  Date your successful award announced: Year :
  Date your successful award received :    Year :
  Name of Country issuing award :
  Name of organization(s) and/or governmental agency(ies) sponsoring award:
 
 

Name and addresses of organization(s) that assess, evaluate and select award:

 
 

Category(ies) that your award qualified in:

 

Name(s) of all other national winners in these categories, if any (list all) :

 
 
The National Quality Award Organization or the candidate must include in its NQA and feedback / site visit report that the GPEA Application documents reflect the organization’s actual operations. Please furnish dates of site visit(s) by the organizers of your national award and provide support documentation(preferably a letter from the organizer). Locations and Dates Visited.
 
Location : Date visited : Year :
 
The National Quality Award Organization must recommend the organization as a candidate for the Global Performance Excellence Award. Please attach appropriate documentation to meet this requirement. This correspondence must be specifically addressed to Global Performance Excellence Award committee, it must recommend your organization and it must be signed by a current officer of the National Quality Award Organization.
 
Attach a copy of awatrd certificate, citation or news release documenting your award.
 
Visit: www.baldrige.nist.gov and www.efqm.org for criteria
 
10. Submission of Documents for the GPEA:

All materials must be in English. Please submit four (4) complete copies of Baldrige Application, four (4) complete copies of National Quality Award (NQA) feedback / site visit report, one (1) copy of the evidence as a National Quality Award winner, one (1) copy of GPEA Application and Eligibility Certification Form and all supporting materials/documents to:

DR. CHARLES A. AUBREY II
Anderson Packaging
4545 Assembly Drive, Rockford, IL 61109
U.S.A.

11. Payment Procedure :

a. Mail your check in US$ 2,000.00 for APQO member country and US$ 2,250 for APQO non-member country and addressed to Asia Pacific Quality Organization (registered mail to avoid tax charges) together with a copy of the filled-up GPEA Application and Eligibility Certification Form to the APQO Executive Office.

b. Feedback Report - US$ 500 (optional)


APQO Executive Office Address:

VICTORIA M. VALLESTERO
Asia Pacific Quality Organization
No. 45 Hybrid St., Phase VI,
GreenWoods Executive Village,
Cainta Rizal, PHILIPPINES 1900

OR

b. Deposit the amount (consider tax charges) and write the following: 

Name of Payee: ASIA PACIFIC QUALITY ORGANIZATION
Name of Payer: (Name of the person or representing organization)
Bank Name: Bank of the Philippine Islands
Bank Address: BF Homes Branch, Aguierre Avenue cor. Elsie Gaches St.,
  BF Homes Subdivision Phase I, Paranaque City, Philippines
 
Dollar Savings Account No. 8254-0274-65
Swift Code:  BOPIPHMM
 
Note:
To inform us of your payment, please send a copy of the bank wire transfer form thru e-mail at:admin@apqo.org



The Global Performance Excellence Award is based on the U.S. Malcolm Baldrige National Quality Award (MBNQA) or European Foundation for Quality Management (EFQM). All applicants must submit their application form along with the feedback / site visit report addressing all criteria items according to the MBNQA requirements. Application forms are available and can be downloaded from our website: www.apqo.org

If your National Award uses the MBNQA format, copies, in English, of your original award application will suffice.

Additional Supporting/Required Material:

  • Copy of your application for your National Quality Award (in English).
  • Completed Malcolm Baldrige National Quality Award Application. Note: Not required if your national award is based on MBNQA. (Applications can be no longer than 60 pages total maximum with no additional documents. Extra pages and documents will be removed from the evaluation).
  • Current Organizational Description (See MBNQA current Criteria for Performance Excellence requirements). (Limit 5 pages). (OPTIONAL)
  • Current Organizational Challenges (See MBNQA current Criteria for Performance Excellence requirements). (Limit 5 pages). (OPTIONAL)

12. Self-Certification Statement, Signature—Highest-Ranking Officer

I certify that the answers provided are accurate and that my organization is eligible based on the current requirements for the Malcolm Baldrige National Quality Award. I understand that at any time during the Award Process cycle, if the information provided was inaccurate, my organization will no longer be eligible for the award.


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Download GPEA Application Form 2012.docx
Download GPEA Brochure 2012