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Online Application for TPM Awards

Deadline for applications is 31st January 2012.

For late applications please contact Tomomi Austin-Bailey on +44 (0)121 717 6619.

Guidance Notes

  • Please complete the form below with all relevant details
  • When you click on the 'Submit' button your application will automatically be submitted to your assessment agency.
  • Additionally,a printed copy of your application form will be produced. This should be signed by the company TPM official and sent by courier to your assessmemt agency
  • When we receive both online application and posted application we will acknowledge by email receipt of these submissions. If acknowledgement is not received within 3 days please contact us.
  • All fields on the form below are required.

Application for 2012 TPM awards

Company Information
1.1 Company name:
1.2 Company Plant Name (if different):
1.3 Address of Plant:
Address line 1:
Address line 2:
City:
Postcode:
Country:
People Information
2.1 Plant Senior Manager
(Plant Manager, MD, CEO)

Given Name:
Family Name:
Title:
Contact Telephone:
Email Address:
2.2 Plant Contact for TPM
(Normal contact person for TPM matters)

Given Name:
Family Name:
Title:
Contact Telephone:
FAX No:
Email Address:
2.3 Finance Contact
(To whom invoices and other finance matters may be addressed)

Given Name:
Family Name:
Title:
Contact Telephone:
Email Address:
Awards Category
Please select one from the list
Award for TPM Excellence, Category A Special Award for TPM Achievement
Award for TPM Excellence, Category B Advanced Special Award for TPM Achievement
Award for Excellence in Consistent TPM Commitment Award for World-class TPM Achievement
Additional Plant Information
4.1 Product Range:
4.2 Annual Turnover (State Currency):
4.3 Number of Employees:
4.4 Total Size of Site (m2):
4.5 Number of days required to complete the assessment:
Consultant(s)
The name of your regular consultant and also the name(s) of any other person(s) performing consulting services such as one day consulting, special visit and Health check are requested
Name of Consultant Name of the Consulting Firm
This is required to avoid any risk of a conflict of interest between a consultant and that same person being appointed as an assessor.
Local Information
6.1 Nearest Airport Name:
6.2 Travelling time from Airport to Plant:
6.3 Suggested Hotel
where assessors may stay:

Name:
Address:
Hotel Contact Telephone:
Hotel Fax Number:
6.4 Travelling time from Airport to Hotel:
6.5 Travelling time from Hotel to Plant:
TPM Information
7.1 Completion of Step 4 Autonomous Maintenance: YES  NO
7.2 Do you already have a TPM Award? YES  NO
7.3 If YES, Category of Award:
7.4 Year of Award
Serious Accidents
Have you had any serious accidents in the last 12 months?
If YES, Accident Report must be attached 		(Please tick appropriate box) YES NO
Signature

Please Note: An original application form will automatically be printed when the above form is submitted. The form MUST be signed and submitted by courier to the address below in time to meet the deadline.

By signing this form you are entering into an agreement between the TPM Applicant for 2012 as stated herewithin and Assessment Agency. This agreement is valid from the date of the application and until all maters between the TPM Applicant for 2012 and Assessment Agency relating to the 2012 TPM Awards are closed.
Signature Date
Please print name
Title
Contact Details
SMMT TPM Assessment
2410 Regents Court, The Crescent,
Birmingham Business Park, Birmingham B37 7YE
United Kingdom
TEL: +44(0)121 717 6619    FAX: +44(0)121 6699 		TPM Contact: Tomomi Austin-Bailey (Mrs)
Email: TPMassessment@smmt.co.uk
Telephone: +44(0)121 717 6619
First and Second Stage Assessment

8.1 Please indicate public holidays and plant closure dates:

Plant Closures

List dates one per line in day/month/year format)

Public Holidays

List dates one per line in day/month/year format)
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