QCC+Application Registration+Form

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The document appears to be an application form from the National Productivity Organization of Pakistan for organizations interested in implementing Quality Control Circles (QCC) within their operations.

The purpose of the application form is for organizations to apply for assistance from the NPO in setting up Quality Control Circles within their operations under the NPO's QCC Implementation Program.

The form requests basic information about the applicant organization as well as more specific information like current issues/problems, suggested areas for a QCC to focus, management commitment, and details about any existing QCCs.

National Productivity Organization

Ministry of Industries, Production & Special Initiatives


Government of Pakistan
FOR OFFICIAL USE
QUALITY CONTROL CIRCLES*
ONLY
APPLICATION / REGISTRATION FORM
Application/
Note: Registration No.:
Please tick appropriate section (Section-1 & Section-4 are compulsory, please provide______________
complete details)
□ Section-2: Application for acquiring the NPO services for QCC Implementation Program
□ Section-3: Registration of existing QCCs

SECTION-1: BASIC INFORMATION / DETAILS

Particulars of the Applicant:


Name of the Firm/
Company

Full Address

Tel: Mobile: Fax:

Telex: E-mail: Website:

Name of the Representative of the company with designation:

Name of the Chief Executive:

Residential Address: Tel:


Mobile:

Basic Information:
1 Goods Manufacture: a. Manufacturing Capacity:
. _____________________________ b. Address (Factory):
____________________________________________
____
c. Telephone (Factory):
____________________________________________
____
____________________________________________
____
____________________________________________
____
2 Year of Establishment: d. No. of employees:
.
3 Any other business (optional) - give Type of Staff No. of People
. items: Managemen
Higher
t
Middle
Lower
Technical Staff
Lower Staff
Please write your Vision / Mission Statements Organizational Objectives:

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Organizational Objectives:

Certifications Status: ISO 9001:2000 Certified Not Certified Under


Process
ISO 14000 Certified Not Certified Under Process
SA 8000 Certified Not Certified Under Process
Any Other
______________________________________________________________________

SECTION-2: APPLICATION FOR ACQUIRING NPO SERVICES TO


IMPLEMENT QCCs UNDER QCC IMPLEMENTATION PROGRAM
Problems facing during working / production:

Suggested Corrective Action to the above problems (optional):

Why you want to implement QCC in your organization (objective)?

In what department you suggest to implement QCC?


(Please attach brief Process Flow, and give the name / designation of person incharge of that
department)

What are the basic problems in that department (your opinion)?


Frequent Machine Breakdown Wastages Lack training /
Lack Skills
Rework High cost of production Employee Turnover
Occupational Health & Safety Housekeeping
Any Other:
_________________________________________________________________________________________
Are you using any tools for controlling your production or problem identification?
Yes No (if Yes, please specify below)
Brainstorming Tally Charts Pareto Analysis
Histograms Cause & Effect Analysis Control Charts
Other -
_________________________________________________________________________________________________
_
Nominate QCC Facilitator: Designation:

(Note: Should be Manager & above, so that he/she can play an instrumental role and can act
as Master Trainer for QCC afterwards. Please also provide, if possible, his/her biodata along
with the detail of trainings that he/she has already attended)

SECTION-3: REGSITRATION OF ALREADY EXISITNG QCCs

General Information about QCCs in the organization:


No. Of Circles: No. of members in each Circle:
Sr Circle Name Circle Type Name of Facilitators
.
1.

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National Productivity Organization
2.
3.
4.
5.
Rate of QCCs per Annum:
Name of QCC Trainer:
Management Commitment: YES NO
Deficiencies of the Circles:

Outcome after QCC implementation:

Are results measurable (if so, please specify and use extra sheet if necessary):

Application of other QC Tools:

Information about QCC to be registered:


Name of the Circle: Type of the Circle: How old Circle is?
Name of the Facilitator With Designation
Are the members of Circle team trained? (If yes, please specify areas of trainings)
YES NO
Brainstorming Tally Charts Pareto Analysis
Histograms Cause & Effect Analysis Control Charts
Other -
_________________________________________________________________________________________________
_
Problem Identified (Attach presentation for details):

Summary of Corrective Actions:

Next Target for QCC:

Rate of QCCs per Annum: Time spent on QCC activity:

Outcome after QCC implementation:

Are results measurable (if so, please specify and use extra sheet if necessary):

Benefits in terms of Cost Process Production


Productivity
Quality Other
________________________________________________
Graphical Analysis (which QC Tools are applied, attach analysis report):

Note: REGISTRATION FEE FOR EACH CIRCLE IS Rs. 300/- (Per Annum) ONLY.

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National Productivity Organization
(Draft/Pay Order in favour of “NATIONAL PRODUCTIVITY ORGANIZATION”, Add Rs. 100/- in case
of outstation draft)

SECTION-4: DECLARATION
I hereby declare that the information as provided by me in this document is true and accurate. I
understand and accept that any false declaration of information on my part will disqualify me.

I hereby also undertake to abide by the regulations prescribed by the NPO.

DATE (DAY-MONTH-YEAR): _________________ SIGNATURE of CHIEF


EXECUTIVE
STAMP:

(PLEASE ATTACH EXTRA SHEETS WHERE NECESSARY)


For any other information, please contact:
MANAGER
INNOVATION & QUALITY DIVISION
NATIONAL PRODUCTIVITY ORGANIZATION
MINISTRY OF INDUSTRIES, PRODUCTION & SPECIAL INITIATIVES
GOVERNMENT OF PAKISTAN
4TH FLOOR, ICCI BUILDING, MAUVE AREA, G-8/1, ISLAMABAD
TEL: +92-51-9262885, DIRECT: +-92-51-9262882-4, FAX: +92-51-9262886
E-MAIL: [email protected]
WEBSITE: www.npo.gov.pk

* (for the convenience of our stakeholders / beneficiaries, the Concept of QCC is


attached)

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