1 Company Information2 Contact Information3 Regenerative Organic Operation Details4 ROA5 Certification Information6 Application Fee Business Name*Operation Name*Operation Type*Farmer or RancherDairyGrower Group or Co-opProcessorBuyers and brands, please do not fill out this initial application. Instead, please do fill out our registration form.Additional Information for Grower GroupsIf your operation is grower group, please provide locations showing the general geographical distribution of growers so that your CB can estimate length of time needed for an on-site audit. Please provide the following: number of grower groups, average number of workers per farm, number of farmers per group, and maximum number of workers at peak.Are you submitting this application on behalf of an operation?*YesNoTax ID*Operation Location (physical location where production occurs)* City State / Province / Region 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 LinkedInInstagramTwitterFacebook 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 TitlePhone*Email* 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.Total operation acreage*Total certified organic acreage*Total number of acres intended for ROC*Please list all crop types intended for ROC. Include the approximate acreage for each crop in parentheses after the type. Example: mixed vegetables (3), cotton (40), and hemp (13).*Please list all livestock types intended for ROC. Include the number of animals for each in parentheses after the type.Average Number of Workers*Peak Number of Workers*Primary Sales Method(s)*The operation produces of 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?*Number of Processing Facilities included in your operation. If none please answer 0.*What is the anticipated gross regenerative organic production value (raw agricultural material)?*What is the percentage of your operation’s annual revenue (raw agricultural material production) that is projected to represent ROC crop?*Desired Certification Level:BronzeSilverGoldNote: Operations seeking Gold-level certification must obtain a ROC-approved social certification at one or more major stages of manufacturing and processing SECTION 4 - 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 5 – CERTIFICATION INFORMATION1. Which certifications does your operation currently hold? (Check boxes)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 Other If you checked 'Other', please list here: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: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? Date Format: MM slash DD slash YYYY 6. CB preference (please list your preference of Certification Body (1-3) of approved ROC CBs First choice CB preference:EcocertQCSMayacertSecond choice CB preference:QCSMayacertEcocertThird choice CB preference:QCSMayacertEcocertApplication Attachments* Drop files here or Accepted file types: pdf. Please upload a copy of all listed valid certificates, you organic client profile, a copy of your OSP with associated maps (land designated for ROC identified), and any other supplemental documents. Please note that there are limits on file types, please convert all documents to PDFs before uploading. 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. For international applicants, please contact certification@regenorganic.org.NameThis field is for validation purposes and should be left unchanged.
