2009年度TPM赏申请书.doc

Application for 2009 TPM Awards For official use onlyJ:Ctry: 2009年度TPM賞申請書To:Corporate Synergy Development Center1. Company Information公司資訊1.1Company Name 公司名稱English: 中文:1.2Company Plant Name工廠名稱(if different) English中文:1.3Company No. (Taiwan Company Only)統一編號 (僅限台灣廠商)1.4Address of PlantLine1:工廠地址Line2:Post code:Country:中文地址:2. People Information 聯絡人資訊2.1Plant Senior Manager 工廠長(Plant Manager, MD, CEO) Name 姓名English: 中文:Title 職稱Contact Telephone No. 電話Email Address 電子郵件 2.2Plant Contact for TPMTPM事務局聯絡人 (Normal contact person for TPM matters) Name 姓名English: 中文: Title 職稱Contact Telephone No. 聯絡電話 Office: Mobile:Contact Fax No. 電子郵件Email Address2.3Finance Contact 財務聯絡人(To whom invoices and other finance matters may be addressed) Name 姓名English: 中文:Title 職稱Contact Telephone No. 電話Email Address 電子郵件1. Awards Category for which application is being made Please select one from the list and tick the box 請勾選欲申請挑戰之TPM賞類別 Award for TPM Excellence, Category B TPM優秀賞 B類Award for TPM Excellence, Category A TPM優秀賞 A類Award for Excellence in Consistent TPM TPM優秀繼續賞 Special Award for TPM Achievement TPM特別賞 Advanced Special Award for TPM Achievement TPM特別繼續賞 Award for World-class TPM Achievement Commitment TPM世界賞4. Additional Plant Information 其他資訊4.1Product Range 產品類別4.2Annual Turnover (State Currency)營業額 (請註明幣別)4.3Number of Employees 從業員人數4.4Total Size of Site (m2) 面積(m2)4.5Number of days required to complete the assessment 審查所需日數 ( ) day(s)5. Name of Consultant(s) The name of your regular consultant and also the name(s) of any other person(s) performing consulting services such as one day consulting, special visit and Health check are requested 輔導顧問姓名 請填寫貴廠目前之輔導顧問姓名，包含進行單日診斷之顧問Name of ConsultantName of the Consulting Firm顧問姓名顧問所屬公司This is required to avoid any risk of a conflict of interest between a consultant and that same person being appointed as an assessor. *此項資料係為了避免派遣與受審工廠關係過於密切之人員擔任審查工作。Local Information 當地資訊6.1Nearest Airport Name 最近之國際機場6.2Travelling time from Airport to Plant機場至工廠之移動時間6.3Suggested Hotel where Assessors may stay 建議審查員投宿的旅館 Name 名稱 Address 住址 Hotel Contact Telephone No. 旅館電話6.4Travelling time from Airport to Hotel機場至旅館之移動時間6.5Travelling time from Hotel to Plant旅館至工廠之移動時間7. TPM Information TPM資訊7.1Do you already have a TPM Award?是否曾得過TPM賞(Please tick appropriate box) YES NO 7.2If YES, Category of Award如是,得獎之類別為何? 7.3Year of Award 得獎年度7.4For 2009 First Stage Assessment please indicate your preferred weeks (Please mark 5 weeks in order of preference) 請依序選出5個能進行2009年事前審查的周次Week周次Your Choice選項Week周次Your Choice選項Week周次Your Choice選項14March 30-April 319May 4-824June 8-1215April 6-1020May 11-1525June 15-1916April 13-1721May 18-2226June 22-2617April 20-2422May 25-2927June 29-July 318April 27-May 123June 1-528July 6-107.5Please list any Holidays and Plant Closure dates during the Assessment Period請列出審查時間月份內之所有休假日8. Serious Accidents 重大事故Have you had any serious accidents in the last 12 months?於過去12個月內是否曾發生重大事故?(Please tick appropriate box YES NO請於適合之框內打勾選) If YES, Accident Report must be attached 如是,請提交事故報告Signature 簽名Date日期Please print name姓名正寫 TITLE職稱TPM Awards Office TPM賞事務局Corporate Synergy Development Center 財團法人中衛發展中心address:7F, NO.8, TUN-HWA N.RD., Taipei 105, Taiwan 105台灣台北市敦化北路8號7樓 TEL: +886-2-8773-4810 FAX: +886-2-2781-7413TPM Contact:Ms. 葉琇芳Ivy Yeh / 儲祥瑞 Judy ChuE-mail:.twTelephone:+886-2-8773-4810Please Note: An original application form with authentic signature (not a photocopy) must be submitted by courier in time to meet the deadline. Additionally an electr