DCA Certification Engagement Form (For DCA Approved Assessment Firm use only)

Form
SECTION 1: Details of the Approved DCA Assessment Firm wishing to engage on behalf of its client
Unique Reference Code:*
Please provide the Unique Reference Code provided by the client (please ensure that this unique code is referenced on all correspondence.
DCA Approved Assessment Firm*
Organisations Name:
Primary Point of Contact*

PrefixFirst NameLast Name
Email*
Please use your company address as we do not accept free mail addresses due to spam /junk filters
Phone Number*

Area CodePhone Number

SECTION 2 - Details of the Data Centre wishing to undergo DCA Certification
Name of Client *
Please specify the name of the organisation requesting to have its Data Centre DCA Certified
Name of Data Centre *
Please specify the name used by your client to identify the data centre wishing to undergo DCA Certification
Geographic Location of facility*
For example: nearest Town or city)
Please confirm if you have you been officially retained by the client as their DCA approved Assessment Firm ?*

YesNo
Applications will only be accepted if the Approved Assessment Firm has been offically retained by the client. If this is not the case the Approved Assessment Firm will need to obtain this prior to completing this application.
Please confirm if you have authority from the client to act on their behalf in applying for DCA certification of the facility listed above ?*

YesNo
Applications will only be accepted if the Approved Assessment Firm has been given the authority from the cleint to act on their behalf. If this is is not the case the Approved Assessment Firm will need to obtain this prior to completing this application.

SECTION 3 - DCA Certifcation Order Confirmation Details
Type of Assessment/Audit to be conducted *
Please select one of the above options
Purchase Order Number/Ref:*
Copy of Purchase order

Browse Files
Please attach a copy of the purchase order if applicable (Optional) Cancelof
Billing Address*

Company Name and billing department

Address

Town/CityCounty /State / Province

Postal / Zip Code
By Submitting this application form you are entering into a contractual agreement with the Data Centre Alliance for the supply of DCA Certification Services

An invoice will be rasied in line with the service selected and full payment is required prior to the onsite assessment taking place. Full Terms and Conditions
Agreement of DCA Terms and Conditions (see link above for full T&Cs)*

Yes
Signature *

Clear
Please verify that you are human*
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