Needs Assessment Questionnaire

Fill in the questionnaire below for a certification quote.

Company Name

First Name

Last Name

Email Address

Contact Number

Street Address

City

State

Zip Code

Country

Facility Type (select most appropriate)

Manufacturing Facility

Restaurant

Livestock Processing (Farm/Slaughterhouse)

Catering Kitchen

Grocery Store or Marketplace

Distribution Center

Other (Add to special instructions)

Approximate Square Footage

Number Of Products Sold As Halal Or To Be Certified

Number of Total Unique Ingredients:

Urgency? (Delivery Expectation)

Standard Processing

Expedited Processing (Delivery within 10 days)

Your company's size in terms of annual revenue?

$0 - $200,000

$200,001 - $500,000

$500,001 - $999,999

$1,000,000 - $4,999,999

$5,000,000+

How did you hear about us?

Special Instructions