UEBT Membership and certification form v1.1

UEBT application form

For membership and certification
Introduction
Union for Ethical BioTrade (UEBT) is a non-profit association that promotes the sourcing with respect (uebt.org). It is a membership-based organisation, formed primarily by companies actively involved in the sourcing of plant materials in the food, cosmetics, fragrance and flavours, herbal tea and spices sectors.

Among its activities, UEBT offers different certification programmes, including:

- UEBT ingredient certification programme – for all ingredients from biodiversity

- UEBT-Rainforest Alliance herbs and spices programme.

UEBT certification is available only to UEBT members. This means that companies or other entities seeking certification must go through the membership process. An exception covers small farms and cooperatives [1].

To find out more about the categories of UEBT membership and their practical implications, please contact membership@uebt.org.

A single application form is required for the UEBT membership and certification processes. This application form gathers information used by the UEBT Secretariat to define and support these processes. Additional information may be requested from the applicant, if needed. All information exchanged in the membership and certification processes is treated as confidential.

Application fees

In certain cases, applying for UEBT certification requires a non-refundable application fee that is charged upon submission of this application form. Information on fees is available on the website (Link : here). An invoice will be sent to the applicant upon receipt of the signed form.

Membership fees

UEBT members pay an annual membership fee. Fees are based on the annual turn-over of the member organisation.

Information on fees is available on the website (Link : here)

[1] Farms or cooperatives with a total turnover of less than 2 million Euros are considered "small farms" or "small cooperatives." These farms or cooperatives may be certificate holders under UEBT certification programmes without becoming UEBT members. These small farms and cooperatives may opt to become UEBT members, under an integrated membership + certification approach.
I. Contact information
Name of organisation applying for UEBT membership and certification*
please use plain Latin characters
Website*
Contact person for UEBT certification
Contact person name*

First NameLast Name
Contact person position / function title*
Contact person phone number*

Country CodeArea CodePhone Number
Contact person email*
example@example.com
Person authorised to sign the application form
Authorised person name*

First NameLast Name
Authorised person position / function title*
Authorised person phone Number*

Country CodeArea CodePhone Number
Authorised person email*
example@example.com
Billing information
Billing address (to be used in invoice) *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Billing contact name*

First NameLast Name
Billing contact position / function title*
Billing contact phone Number*

Country CodeArea CodePhone Number
billing contact email*
example@example.com
II. UEBT membership and certification applicant information
Brief applicant overview:*
Certification programme which applicant applies for:

UEBT Rainforest Alliance Herbs & Spices certificationUEBT Ingredient certification
Sector(s) in which applicant operates:*

Herbs and spicesFood and beveragesFragrance and flavoursBeauty and personal carePharmaceutical
If other sectors, please add below:
Position in supply chain:*

Farm or cooperativeInitial processingTraderR&DIngredient manufacturerFinal product manufacturerBrand
Is the applicant directly responsible for cultivation or wild collection practices for the herbs, species or other ingredients to be certified? Under UEBT certification programmes, this would be considered an "organisation at source."*

YesNo
Please include any information on the applicant's relationship with farmers, pickers or local producer associations that may be useful to define how UEBT membership and certification requirements apply.
Which category is more representative of your organisation's activities?*

BrandsTraders and processing companiesFarms, cooperatives, and local processing companies
What is the structure of you organisation?*

An independent organisation not belonging to a groupA groupAn entity part of a group
Please list all the entities which are part of the group*
Please specify the group you belong to *
Please upload an organigram of the organisation´s relationship with your suppliers and buyers.*

*This document will help us to understand your supply chain better
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III. Herbs, spices or other ingredients to be certified
How many ingredients [2] does the applicant want to include in the certification scope? Please specify the names of the ingredients to be certified and the countries where they are cultivated or wild collected:*
[2] "Ingredient from biodiversity" and "natural raw material" are terms used interchangeably for the plant that is cultivated or wild collected and that, in its raw form or having undergone initial processing, has been approved for certification under the UEBT certification programmes.
If the applicant is NOT an organisation at source, what and how many are the entities directly responsible for cultivation or wild collection of the ingredients to be certified?
If the applicant is NOT an organisation at source, what and how many are the entities between the applicant and the organisation at source - also known in the UEBT certification programmes as sub-suppliers?
What is the approximate number of producers in the supply chains to be certified? *
Producers are known in UEBT certification programmes as field operators, understood as the farmers, workers, pickers or groups of these persons at primary production level and following same cultivation or wild collection practices.
Location of the producers
Please include the name of the province or state, town and geo coordinates (is possible) of the areas were the plots, farmers are located or of the areas were the collection activities are done (in case it´s wild collection)
Please indicate the type, location and number of infrastructures that will be part of the scope
Please include the name of the province or state, town and geo coordinates (is possible) of the areas were these infrastructures are located or of the areas were the collection activities are done (in case it´s wild collection)
Distance in Km between the producers, processing facilities (if any) and main office
For each ingredient to be certified, approximate volumes to be certified (annual, in tons)*
Are practices along any of the supply chains to be certified, already assessed or monitored in a systematic manner by the applicant?*
For example, are organisations at source or field operators subject to visits or field assessments?
Are any of the ingredients to be certified, already certified under other schemes? If so, please indicate which are these certification schemes.*
IV. Additional points for UEBT membership
UEBT is a member-based non profit association.

Participation in UEBT certification programmes, including the UEBT/RA herbs and spices programme, is limited to UEBT members. That is, to become UEBT certificate holders (CH), companies are also required to become UEBT members.*

*The only exception is for individual farms or farmer or picker organisations with a turnover of less than two million euros, for whom membership is optional but recommended.

UEBT works with companies of all sizes and has flexible solutions to meet the needs of companies wherever they are on their ethical sourcing journey. To that end, membership can be designed for the entire company, or for one division/subsidiary of the company.

The membership scope should refer to a specific, clearly defined, and meaningful department or other entity within the corporate structure. It cannot be limited to a specific natural raw material unless it happens to be a business unit or division in itself.
Please provide an estimate of the number of ingredients from biodiversity - beyond those to be certified - applicant is currently sourcing/producing. Consider all material or compounds derived directly or indirectly from plants, animals, fungi or microbial organisms, also commodities and derivatives. *
Consider all material or compounds derived directly or indirectly from plants, animals, fungi or microbial organisms, also commodities and derivatives.
Applicant's total gross turnover in last fiscal year. Please indicate in EUR.*
Applicant's total gross turnover in the local currency.
Please provide supporting evidence of your total gross turnover (e. g. financial statement, tax returns, etc.):

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Applicant's gross turnover for herbs, spices or other ingredients to be certified, in last fiscal year. Please indicate in EUR.*
Applicant's gross turnover for herbs, spices or other ingredients to be certified, in the local currency.
Would you like to be a UEBT member?*

Yes, I would like to become a UEBT memberNo, I don't want to become a UEBT member
For farms and producer associations such as cooperatives, membership is optional if the organisation’s annual turnover is less than 2 million Euros. However, UEBT membership is recommended.

UEBT membership entails respect for the UEBT Articles of Association (GOV01) and other membership conditions and obligations (GOV25).
What is the scope of UEBT membership ?*

Whole companySpecific division / Business Unit / SubsidiaryFarmOther
Please specify the name of the UEBT Membership scope. *
This is the name that will be used on the Ingredient(s) Certificate and the Membership Confirmation.
UEBT membership scope (subsidiary/division/business unit) turnover in last fiscal year. Please indicate in EUR.*
UEBT membership scope (subsidiary/division/business unit) turnover in local currency
What is applicant’s motivation for UEBT certification?
What benefits are expected from UEBT certification?
How did applicant hear about UEBT?*
V. Membership terms and conditions
Through this application, the applicant commits to sourcing with respect for people and biodiversity. UEBT members set targets and take measures towards gradually improving their sourcing systems and practices in line with the Ethical BioTrade Standard. UEBT membership also entails respect for the UEBT Articles of Association (Link : GOV01) and other membership conditions and obligations (Link : GOV25).
I have read and understood the UEBT Articles of Association and the UEBT membership conditions and obligations
VI. Authorisation
I, blanks* , being the duly authorised representative of the applicant, do hereby declare that all the information contained in this application is correct, and that the applicant understands and agrees to comply with UEBT membership terms and conditions, as outlined above.
Signature*

Clear
Name*
Place*
Date*

DayMonthYear
Date
Please verify that you are human*
Should be Empty:

UEBT application form

Introduction

I. Contact information

Contact person for UEBT certification

Person authorised to sign the application form

Billing information

II. UEBT membership and certification applicant information

III. Herbs, spices or other ingredients to be certified

IV. Additional points for UEBT membership

V. Membership terms and conditions

VI. Authorisation