SECTION 1 - COMPANY INFORMATIONOperation 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 production Livestock production Processing and handling What is your organizational structure?*ProducerICS Managed grower groupCo-opOtherOperation 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 FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Company Phone*Online presence:Do you have an active website? Yes No Website Do you have a social media site(s)? Yes No LinkedIn Instagram Twitter Facebook SECTION 2 - CONTACT INFORMATIONPlease designate one person in your operation to be the ROA’s primary contact. This person will be listed on the Regenerative Organic Certified® online directory. 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.Name* First Last Title* Phone*Contact Email* Is there a representative from another organization that should be copied on all correspondence?*YesNoIf you answered yes above, please fill out the following information First Last Email Organization name Producer License AgreementDownload and complete the ROA Producer License Agreement (fillable form PDF) and upload as an attachment to this form. Upload Producer License Agreement*Accepted file types: jpg, pdf, png, docx, doc, Max. file size: 5 MB.SECTION 3 - OPERATION DETAILSHelp us understand your operation better so that we can efficiently process your application. .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 to be Regenerative Organic Certified®*Please note: only certified organic land is eligible to be Regenerative Organic Certified®How many distinct parcels does your operation intend to be Regenerative Organic Certified®?*Distinct parcels are defined as readily distinguishable from each other with no adjacent or touching borders.Please list all crop types intended to be Regenerative Organic Certified® 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 to be Regenerative Organic Certified® 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). What is your estimated value of all Regenerative Organic Certified® eligible crops and livestock for the current calendar year?See Cost and Fee Structure 2.3 for more information. What estimated percentage of your operation’s revenue will be from Regenerative Organic Certified® sales?* Average number of workers at the operation level annually*Peak number of workers at the farm level* 0 permanent workers and no more than 5 total workers on-site at any one time 1-5 permanent workers and no more than 25 total workers on-site at any time 6-25 permanent workers and no more than 100 total workers on-site at the operational unit at any one time 25+ permanent workers and more than 100 total workers on-site at operation unit at any one time Select all worker status that applies* Permanent Seasonal / temporary Full-time Part-time Close relatives/ family workers only No workers Total number of seasonal / temporary workers?List total number of permanent workersList months that seasonal / temporary workers are on-site Do you use farm labor contractors?* Yes No How many labor contractors?*On average how many workers are onsite at any one time?*How many days per week per year?* Do you employ any H2A workers?* Yes No On average how many workers are onsite at any one time?*How many days per week per year?* Do you employ young workers?* Yes No On average how many workers are onsite at any one time?*What is the primary language spoken by the farm workers?* Do all members meet the definition of smallholder?For ICS managed grower groups, the definition of smallholder is - small farming operations where land and labor productivity are comparatively low due to limited resources. Smallholder farmers often rely on farming as a primary means of livelihood and are at greater risk of vulnerability in the supply chain. Smallholders rely primarily on family labor for farm operations. Smallholder size may vary by farm type and commodity; however, some certifications set thresholds so confirm with your certification program, if applicable. Most smallholders are organized by Internal Control System (ICS) for certification purposes. Yes No The operation produces or handles (choose one):* Organic, nonorganic, and Regenerative Organic Certified® products Organic and Regenerative Organic Certified® products Nonorganic and Regenerative Organic Certified® products Regenerative Organic Certified® products only Do you intend to have processed products with a Regenerative Organic Certified® claim (including ingredient statements)?* Yes No If yes, then the ROA will issue you a license listing the products eligible to be sold with Regenerative Organic Certified® claims.Submit a Claimed Material Worksheet listing your product formulation and supply chain description.Accepted file types: pdf, jpg, png, Max. file size: 5 MB.Will any intended Regenerative Organic Certified® products be processed at an off-site contracted facility? Yes No If yes, you will need to complete a Supply Chain Actor Disclosure Form.Upload the completed Supply Chain Actor Form. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. If yes, please upload the organic certificate for each facility. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. What is your estimated gross revenue for the current calendar year from processed products making Regenerative Organic Certified® claims?*See Cost and Fee Structure 2.4 for more information. HiddenDesired Certification Level (ARCHIVED, NOT LIVE. 9/12/23):Note: Gold level Regenerative Organic Certified® requires long-term planning and has additional requirements to achieve. BronzeSilverGoldSECTION 4 – CERTIFICATION INFORMATION(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*An ROA approved third party social certificate is required unless undergoing a full Regenerative Organic Certified® social audit if you are located in the global north. The certificate must be attached to this application and an opportunity will be provided in the next section to upload your a copy of your certificate. Equitable Food Initiative Fair for Life Fair trade International Fair Trade USA Fair TSA G.R.A.S.P. Naturland Fair Standards on Production Small Producer Symbol World Fair Trade Organization N/A (located in the 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. Please list the countries/markets you export to or plan to export to directly or indirectly (as an ingredient or through brokers/traders etc.)What is your target date for certification* MM slash DD slash YYYY Please list your current organic certifier.* Are you seeking to bundle Regenerative Organic Certified® services with your current organic certifying body (CB)?*This option is only applicable to those CBs who have been approved by the ROA. See below for ROA approved CBs. If you mark yes, we will immediately begin copying the CB of choice on correspondence related to the application process. Yes No Select ROA approved CB for audit:*Please select the CB below for your Regenerative Organic Certified® audit. See ROA Approved Certifying Bodies on our regenorganic.org/resources for more information. ACO Certification Bioagricert CERES - CERtification of Environmental Standards GmbH Control Union Ecocert IBD Certifications ICEA - Istituto per la Certificazione Etica e Ambientale IMOcert Latin America Mayacert OIA - Organización Internacional Agropecuaria Pro-Cert Certifications QCS SCS Global Where Food Comes From Organic (WFCFO) Supplemental DocumentsPlease upload the necessary supplemental documents. All documents applicable to your operation are required in order to process your application. Documents must be in PDF, JPEG, PNG, .XLSX, or .DOCX format. 50MB file size limit (total for all files). if the combined size of your files is larger than 50MB, we suggest using a secure cloud storage location such as Dropbox, OneDrive, or GoogleDrive and sharing the file location. If you experience any issues uploading your files, please contact certification@regenorganic.org.HiddenOrganic certificates (deprecated)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.Accepted file types: pdf, doc, png, jpg, Max. file size: 5 MB.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, png, doc, jpg, docx, Max. file size: 5 MB, Max. files: 5. Organic System Plan (OSP)* Drop files here or Select files Accepted file types: pdf, Max. file size: 5 MB, Max. files: 1. 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, xls, xlsx, png, jpg, doc, docx, Max. file size: 5 MB, Max. files: 3. MapsPlease include documents that show the acreage under your organic certificate and land designated to become Regenerative Organic Certified®. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 10 MB, Max. files: 5. Animal Welfare Certificate Drop files here or Select files Accepted file types: pdf, Max. file size: 5 MB, Max. files: 3. Social Fairness Certificate Drop files here or Select files Accepted file types: pdf, Max. file size: 5 MB, Max. files: 3. Additional certificate(s) for additional ROA recognized certifications Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 5. Additional document(s) or material(s) Drop files here or Select files Accepted file types: pdf, png, jpg, doc, docx, xlsx, xls, Max. file size: 10 MB, Max. files: 5. Link to cloud storage if applicableIf files are larger than 50MB total, we suggest using a secure cloud storage location such as Dropbox, OneDrive, or GoogleDrive and sharing the file location here. If you need assistance, contact certification@regenorganic.org SECTION 5 - NEXT STEPSPlease be advised that the process from application to certification may take anywhere from three to six months. The duration of the application process depends on your response time to ROA inquiries, certifying body availability, audit timing, and corrective actions required. Certification is not guaranteed. Please add certification@regenorganic.org and accounting@regenorganic.org to your email contacts to ensure you receive our correspondence.APPLICATION PROCESS Your application will be reviewed and processed in the order received The ROA reviews the application and will send an email to you with a customized Regenerative Organic System Plan (Part 2 of the application process) and request any missing documentation. Applicant submits completed ROSP, the ROA confirms the applicant package is ready for the certifying body (CB) and assigns it to a CB of the applicant’s choice. The CB conducts application review, on-site audit/report, and final annual review. Any nonconformances are addressed by the applicant. Final certification recommendation is issued by CB to the ROA. The ROA awards certificate. Thank you for FARMING LIKE THE WORLD DEPENDS ON ITEmailThis field is for validation purposes and should be left unchanged. Δ
