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Personal Particulars
Title (e.g. Mr, Ms, Mrs, Prof, Dr, Rev)
First Name
*
Last Name / Surname
*
Email Address
*
Secondary Email Address
Mobile Number
*
Phone Number
City/Town/Village/Farm
State/Province/Region
*
Country
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Afghanistan +93
Albania +355
Algeria +213
American Samoa +1 -684
Andorra +376
Angola +244
Anguilla +1 -264
Antarctica +672
Antigua and Barbuda +1 -268
Argentina +54
Armenia +374
Aruba +297
Ascension +247
Australia +61
Austria +43
Azerbaijan +994
Bahamas +1 -242
Bahrain +973
Bangladesh +880
Barbados +1 -246
Belarus +375
Belgium +32
Belize +501
Benin +229
Bermuda +1 -441
Bhutan +975
Bolivia +591
Bonaire +599
Bosnia and Herzegovina +387
Botswana +267
Brazil +55
British Virgin Islands +1 -284
Brunei +673
Bulgaria +359
Burkina Faso +226
Burundi +257
Cabo Verde +238
Cambodia +855
Cameroon +237
Canada +1
Cayman Islands +1 -345
Central African Republic +236
Chad +235
Chile +56
China +86
Colombia +57
Comoros +269
Congo, Democratic Republic of the +243
Congo, Republic of the +242
Cook Islands +682
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Croatia +385
Cuba +53
Curaçao +599
Cyprus +357
Czech Republic +420
Denmark +45
Diego Garcia +246
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Dominica +1 -767
Dominican Republic +1 -809 and +1 -829
Ecuador +593
Egypt +20
El Salvador +503
Equatorial Guinea +240
Eritrea +291
Estonia +372
Eswatini +268
Ethiopia +251
Falkland Islands +500
Faroe Islands +298
Fiji +679
Finland +358
France +33
French Guiana +594
French Polynesia +689
Gabon +241
Gambia +220
Georgia +995
Germany +49
Ghana +233
Gibraltar +350
Greece +30
Greenland +299
Grenada +1 -473
Guadeloupe +590
Guam +1 -671
Guatemala +502
Guinea +224
Guinea-Bissau +245
Guyana +592
Haiti +509
Honduras +504
Hong Kong +852
Hungary +36
Iceland +354
India +91
Indonesia +62
Iran +98
Iraq +964
Ireland +353
Israel +972
Italy +39
Jamaica +1 -876
Japan +81
Jordan +962
Kazakhstan +7
Kenya +254
Kiribati +686
Kosovo +383
Kuwait +965
Kyrgyzstan +996
Laos +856
Latvia +371
Lebanon +961
Lesotho +266
Liberia +231
Libya +218
Liechtenstein +423
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Luxembourg +352
Macau +853
Madagascar +261
Malawi +265
Malaysia +60
Maldives +960
Mali +223
Malta +356
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Martinique +596
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Mauritius +230
Mayotte +262
Mexico +52
Micronesia, Federated States of +691
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Monaco +377
Mongolia +976
Montenegro +382
Montserrat +1 -664
Morocco +212
Mozambique +258
Myanmar +95
Namibia +264
Nauru +674
Nepal +977
Netherlands +31
New Caledonia +687
New Zealand +64
Nicaragua +505
Niger +227
Nigeria +234
Niue +683
Norfolk Island +672
North Korea +850
North Macedonia +389
Northern Mariana Islands +1 -670
Norway +47
Oman +968
Pakistan +92
Palau +680
Palestine +970
Panama +507
Papua New Guinea +675
Paraguay +595
Peru +51
Philippines +63
Poland +48
Portugal +351
Puerto Rico +1 -787 +and +1 -939
Qatar +974
Reunion +262
Romania +40
Russia +7
Rwanda +250
Saba +599
Saint-Barthelemy +590
Saint Helena +290
Saint Kitts and Nevis +1 -869
Saint Lucia +1 -758
Saint Martin (French side) +590
Saint Pierre and Miquelon +508
Saint Vincent and the Grenadines +1 -784
Samoa +685
San Marino +378
Sao Tome and Principe +239
Saudi Arabia +966
Senegal +221
Serbia +381
Seychelles +248
Sierra Leone +232
Singapore +65
Sint Eustatius +599
Sint Maarten (Dutch side) +1 -721
Slovakia +421
Slovenia +386
Solomon Islands +677
Somalia +252
South Africa +27
South Korea +82
South Sudan +211
Spain +34
Sri Lanka +94
Sudan +249
Suriname +597
Sweden +46
Switzerland +41
Syria +963
Taiwan +886
Tajikistan +992
Tanzania +255
Thailand +66
Timor-Leste +670
Togo +228
Tokelau +690
Tonga +676
Trinidad and Tobago +1 -868
Tristan da Cunha +290
Tunisia +216
Turkey +90
Turkmenistan +993
Turks and Caicos Islands +1 -649
Tuvalu +688
Uganda +256
Ukraine +380
United Arab Emirates +971
United Kingdom +44
United States of America +1
Uruguay +598
Uzbekistan +998
Vanuatu +678
Vatican City State +39
Venezuela +58
Vietnam +84
U.S. Virgin Islands +1 -340
Wallis and Futuna +681
Yemen +967
Zambia +260
Zimbabwe +263
My Birthday is on
LinkedIn Name
LinkedIn Url
I can conduct business in either of the following languages (you can select more than one)
Arabic
Chinese
Dutch
English
French
German
Greek
Hindi
Indonesian
Italian
Japanese
Korean
Portuguese
Russian
Spanish
Thai
Turkish
Vietnamese
Current Occupation
Employer Name
*
Job Title
*
My main job mission is to
*
I report directly to the (select Governing Body in case you also own your organization)
*
Governing body (e.g. Board of directors/Legislature)
Executive Head of the Organization (e.g. President/CEO/Managing Director, Governor, Mayor)
Member of the Executive/Top Management (who reports to the Executive Head)
Head/Manager of a department (who reports to the member of the Executive)
A Section Head/Senior Specialist (who reports to the Head/Manager of a department)
My primary employer is a
*
Private sector organization (profit making)
Private sector organization (non-profit making)
Government (Legislature or Administration of a Supranational/National/State/Provincial/Local government)
Semi-autonomous governmental organization (e.g. a public or statutory regulatory organization)
Government/State Owned Entity
Are you self-employed (i.e. your primary employer)?
Yes
No
Our industry sector is
Accommodation, Tourism, Catering, Conferencing
Activities of households as Employers
Art, Entertainment, Sport, Cultural activities
Agriculture, Forestry and Fishing
Animal health and welfare (e.g. Vets, Animal shelters; Animal grooming services)
Association of members - Voluntary (e.g. Professional bodies, Clubs)
Broadcasting and Journalism
Civic and Community Based organizations
Construction and Maintenance of Infrastructure
Education and Training (Primary/Elementary and Secondary)
Education and Training (Tertiary/Higer Education)
Energy (Electricity generation, transmission, distribution and retail, Gas, Petroleum)
Financial and Insurance services
Government and Public Administration - National (e.g Legislature; Executive branch of Government; Public service; Judiciary; Constitutional/Statutory bodies)
Government and Public Administration - Supranational (e.g. United Nations and its Agencies, African Union, European Union; Public service; Judiciary; Statutory bodies)
Human health & Social work (e.g. Hospitals, Clinics, Medical and emergency services, Mental and Emotional welfare services, Frail care; Counselling services, Gymnasiums, etc)
Human Social services (e.g. Funeral services, Crematoria)
Information Management & Tech (e.g. Data gathering and processing; Software design and development)
Manufacturing of food and Beverages for human consumption
Manufacturing of medicines for human use
Manufacturing of cosmetics and hygiene products
Manufacturing of medical devises
Manufacturing of food for animals
Manufacturing of medicines for animals
Manufacturing of motorized vehicles, aerospace vehicles, ships, other transport equipment, trailers, tractors)
Manufacturing of chemicals and chemical-based products
Manufacturing of ICT hardware (e.g. computers, servers and related accessories, telephones, radios)
Manufacturing of heavy industrial machinery and equipment (e.g. assembly lines, equipment for energy sector, etc)
Manufacturing of weapons and related systems
Manufacturing of paper and Pulp
Manufacturing of electronics, household appliances
Manufacturing of Other (e.g. textiles, glass, furniture, jewellery, building materials, etc)
Mining and Quarrying
Non-Governmental Organization
Philanthropy (e.g. Charities and charitable activities)
Political Organizations
Professional Body (statutory)
Professional Services (e.g. Legal services; Public Relations; Management Consulting; HR services, Auditing; Research; Engineering; Quality; Safety, Environmental, etc)
Publications, Motion Pictures,
Real estate
Religious body
Scientific and Reaserch activities (e.g. Clinical, Medical, Industrial, Human, Environmental, etc)
Social, Print and e-media
Telecommunications
Trade Union; Federations of Trade Unions
Transportation, Courier Services and Storage
Water supply; Sewage; Waste Management
Wholesale and Retail (including eWholesalers and eRetailers)
Experience in management or equivalent senior level roles, and associated competencies
My total years in Management or equivalent senior level positions in the field of Quality Management (only those with 8 years or more of experience are eligible to apply)
8 - 9 years
10 - 14 years
15 - 19 years
20 - 24 years
25 years and more
If you are not currently in a Quality Management type management or equivalent senior role, and do not have any prior working experience in the Quality field, then indicate your total years of experience (only those with 8 years or more experience are eligible to apply)
*
Not applicable (select this response if you have already indicated in the preceding question that you have experience in the Quality field)
8 - 9 years
10 - 14 years
15 - 19 years
20 - 24 years
25 years and more
Highest formal academic qualification(s) obtained at
Primary/Elementary School
High School
College/Technical level
University (non-degree)
University (degree(s)
Do you have any previous exposure or working familiarity with the ISO 9001:2015 standard?
Yes
No
Did you attend a course in ISO 9001:2015, and do you possess a valid certificate as proof?
Yes
No
Do you have any previous working experience as a member of a governing body of an organization?
Yes
No
Do you possess a valid certificate from a recognized body/institution for you to practice as a Director/a member of a governing body of an organization?
*
Yes
No
Are you currently a member of a Professional Body(ies) in the field of Quality, and if so, which country is the body based in? (if expired, select "No")
Yes
No
Please provide the name and country of the Professional Body(ies) in the field of Quality you are a member of:
Are you currently a member of any other Professional Body(ies), and if so, what is the body's field of focus (e.g. Health profession, Engineering, Pharmacology, Financial) and which country is the body based in? (if expired, select "No")
Yes
No
Please provide the name, field of focus and country of the other Professional Body(ies) you are a member of:
Are you currently a member of /a participant in any public or private Regulatory or Standards-setting type Body(ies)? (if expired, select "No")
Yes
No
Please provide the name, field of focus and country of the Body(ies) and Indicate if Regulatory or Standards-setting.
How did you hear about us? (you can select more than one)
*
Conference/Seminar
Leaderhip or Staff of this organization
My Supervisor
My Professional or other Body which I am involved in
Public or community focussed programmes/campaigns
Community Quality activist
A current member of this organization
Internet search/Your website
LinkedIn
X
Facebook
News article/broadcast
Educational institution (e.g. school, university)
Direct marketing (e.g. Brochure, advert)
Other
Given that a culture of good quality requires of me to do the right things and to do those things right all the time, I derive my spiritual inspiration and guidance from participating in or following the faith of
Catholicism
Anglicanism
Lutheranism
Methodism
Presbyterianism
Dutch Reformed
Evangelicalism
Episcopalism
Baptist
Orthodoxism (e.g. Greek, Eastern, Russian, Oriental)
Pentecostal
Calvinism
Adventism
Assembly of God
Islam
Hinduism
Chinese traditional religion
Buddhism
Primal-indigenous (e.g. Native American traditional religion)
Sikhism
Juche
Spiritism
Judaism
Bahai
Jainism
Shinto
Cao Dai
Zion Christianism (African initiated)
International Pentecost Holiness (Ntate Modise - African Initiated)
Nazareth Baptism (African Initiated)
Ethiopian Orthodoxism (African Initiated)
Apostolic Faith (African Initiated)
Aladura Pentecostal
Other religion or faith not listed above
No particular religion or faith
Please type the name of the religion or faith if not listed above
Only fill in if you are not human
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