1Company Information2Contact Information3Regenerative Organic Operation Details4ROA5Certification Information6 Operation or farm name applying for certification*This must be the entity listed on the organic crop production certificate. Please list any affiliated businesses or brands* Type of operation*Crop productionLivestock productionProcessing or handlingWhat is your organizational structure?*ICS ManagerGrower groupCo-opSingle ProducerOtherOperation location (physical location where production occurs)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Company Phone*Online presence:Website LinkedIn Instagram Twitter Facebook CONTACT INFORMATIONPlease designate one person in your operation to be the ROA’s primary contact. This person will be listed on all ROC online directories. This person should be knowledgeable of your operation, your ROSP, your operation’s activities and applicable regenerative organic standards, and have the authority to act on behalf of your organization. All communications will be sent to this contact. Please add certification@regenorganic.org to your contact list so emails are not lost.Name* First Last Title* Phone*Contact Email* Is there a representative from another organization that should be cc'ed on all correspondence?*YesNoIf you answered yes above, please fill out the following information First Last Email Organization name Operation Information & Certification Contract*Please upload a completed and signed copy of the Operation Information & Certification Contract (available at RegenOrganic.org/Resources).Accepted file types: jpg, pdf, Max. file size: 50 MB. SECTION 3 - REGENERATIVE ORGANIC OPERATION DETAILSHelp us understand your operation better. Failure to complete the items applicable to your operation will result in a delay in your application processing.Unit of measurement*Please choose which unit you use to measure your farm.AcresHectaresTotal acres/hectares under your operation's management*Total number of acres/hectares intended for ROC*Please note: only certified organic land is eligible for ROC.How many distinct parcels does your operation intend for ROC?*Distinct parcels are defined as readily distinguishable from each other with no adjacent or touching borders.Please list all crop types intended for ROC as listed on your organic certificate. Include the approximate acreage/hectares for each crop in parentheses after the type. Example: mixed vegetables (3), cotton (40), and hemp (13).* Please list all commercial livestock intended for ROC as listed on your organic certificate. Include the number of each animal type in parentheses.*Example: dairy heifers (30), laying hens (50), and pigs (12). Number of workers at the farm level*Does the operation meet the definition of small-scale operation?*The definition of a small-scale operation is ≤5 permanent workers and no more than 25 total workers on-site at any time. Yes No The operation produces or handles (choose one):* Organic, nonorganic, and ROC products Organic and ROC products Nonorganic and ROC products ROC products only Do you intend to produce any processed products with a ROC claim? If yes, what type of products?* Is there a certified organic processing facility on-site that you would like to be part of the application?*Certification and audit of a processing facility is only required to achieve ROC Gold. This requirement does not apply to farms with no intended processed product. If you are hoping to make processed product with a ROC claim, is there a certified organic processing facility off-site?*If you'd like to make ROC claims on any processed products the processing facility must be certified organic and either register with the ROA, seek ROC certification separately or be included in your ROC application. For Gold, one processing facility must also apply for ROC. What is the percentage of your operation’s annual revenue (raw agricultural material production) that is projected to represent ROC crop?* What is the anticipated annual GROCV or GROPV of the operation (USD)?*GROCV - Gross Regenerative Organic Crop Value GROPV - Gross Regenerative Organic Product Value Desired Certification Level:Note: Gold level required long-tern planning including ROC processor certification, additional social certifications, and other requirements.BronzeSilverGold SECTION 4 – CERTIFICATION INFORMATION1. Which certifications does your operation currently hold? (check all that apply)Soil Health Canadian Organic Regime Demeter Bio-dynamic European Union Organic Japanese Agricultural Standards Korean Food Code Naturland Standards on Production Swiss Organic Ordinances USDA Organic Animal Welfare Animal Welfare Approved Certified Humane Demeter Biodynamic Farm Standard Global Animal Partnership (step 4 or higher) N/A (Bronze Dairy) N/A (no livestock) Other If you checked 'Other', please list here: Social Fairness Agricultural Justice Project Equitable Food Initiative Fair for Life Fair trade International Fair Trade USA Naturland Standards on Production Small Producer Symbol World Fair Trade Organization N/A (Global North) N/A (no employees) Other If you checked 'Other', please list here: If you are currently seeking a third-party social fairness certificate, please indicate the certification scheme and projected audit date below. 2. Please list the countries/markets you export to or plan to export to directly or indirectly (as an ingredient or through brokers/traders etc.)*3. When do you anticipate the need for certification? MM slash DD slash YYYY Please list your current organic certifier.* Are you seeking to bundle ROC services with your current organic certifying body?*This option is only applicable to those CBs who are presently approved by The ROA to offer ROC services. Approved CBs currently include EcoCert, QCS, Mayacert, and ProCert. If you mark yes, we will immediately begin cc'ing your CB on correspondence related to the application process. Yes No Supplemental DocumentsPlease upload the necessary supplemental documents. All documents relevant to the applying operation are required. All documents must be uploaded in PDF format.Organic Certificates*Please attach your organic certificates for every scope of the farm, including processor/handling certificate(s), crop certificate(s), and livestock certificate(s), as applicable. Please include any appendices and/or client profiles. Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Organic System Plan (OSP)* Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Internal Control System (ICS)Please include an approved farmers list showing group names, farm names, locations, acreage, and crops. Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Maps*Please include documents that show the acreage under your organic certificate and land designated for ROC. Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB, Max. files: 5. Animal Welfare Certificate Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Social Fairness Certificate Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Additional certificate(s) for additional ROA recognized certifications Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Additional document(s) or material(s) Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB, Max. files: 5. SECTION 5 - ROA'S MISSIONThe Regenerative Organic Alliance is on a mission to heal a broken system, repair a damaged planet, and empower farmers and eaters to create a better future through better farming. The ROA oversees Regenerative Organic Certified (ROC), a revolutionary new certification for food, fiber, and personal care ingredients. ROC farms and products meet the highest standards for soil health, animal welfare, and farmworker fairness, ensuring that any purchase with the ROC seal has a positive impact environmentally, socially, and ethically. We envision a world free of poisonous chemicals, factory farming, exploitation, soil degradation, habitat destruction, pollution, short-term thinking, corporate bullies, greenwashing, and fake food. Instead, we imagine a world in which farmers, brands, policymakers, educators, researchers, and individuals join together to create a healthy food system that respects land and animals, empowers people, and restores communities and ecosystems through regenerative organic farming. What made you want to apply for Regenerative Organic Certified?This question is optional. By answering this question, you give the Regenerative Organic Alliance your permission to use your response in our communications.How does your farm, brand or operation align with the ROA’s mission and vision?*The ROA would like your permission to use your response to this question in our communications. Please indicate your consent below. If you do not consent, leave the box unchecked.Consent The ROA may use my response in their communications. SECTION 6 - APPLICATION FEEThe ROA charges a one-time application fee based on the size and scope of your operation. The ROA must be notified of payment receipt prior to reviewing your application. Guidance on operation size and scope: If your operation is < five distinct parcels, your fee is $350 USD If your operation is > five distinct parcels, your fee is $550 USD If your operation is a grower group, your fee is $750 USD Upon submission of this form you will be directed to a link to submit payment. International applicants, please submit your application and then visit RegenOrganic.org/International-Payments to submit your application fee. If you experience any issues, please contact certification@regenorganic.org.CommentsThis field is for validation purposes and should be left unchanged.
