2009 Award Application Forms

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Baldrige AwardApplication Forms

National Institute of Standards and Technology

Department of Commerce

Baldrige National Quality Program

2009

Performance Excellence and Innovation


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The Award crystal, composed of two solid crystal prismaticforms, stands 14 inches tall. The crystal is held in a base ofblack anodized aluminum, with the Award recipients nameengraved on the base. A 22-karat gold-plated medallion iscaptured in the front section of the crystal. The medal bearsthe inscriptions Malcolm Baldrige National Quality Award

and The Quest for Excellence on one side and thePresidential Seal on the other.

The President of the United States traditionally presents theAward at a special ceremony in Washington, D.C. The Awardis made annually to recognize U.S. organizations for perform-ance excellence. The Award eligibility categories are

manufacturing businesses

service businesses

small businesses

education organizations

health care organizations nonprofit organizations

Award recipients may publicize and advertise their Awards.Recipients are expected to share information about theirsuccessful performance strategies with other U.S.organizations.

The Malcolm Baldrige National Quality Award

Crystal by Steuben

Opportunity to Increase OrganizationalLearning Using the Baldrige CriteriaIf you would like the opportunity to gain a deeper insight

into the Baldrige Criteria for Performance Excellence andthe Baldrige Award process, you may nominate a seniormember of your organization to be noncompetitivelyappointed to the Board of Examiners. The nomineemust not have served previously as an Examiner for theMalcolm Baldrige National Quality Award. The nomineewill be expected to fully participate as a member of theboard; this includes attending the Examiner PreparationCourse in Gaithersburg, Maryland, and participating inthe evaluation of an organization that has applied forthe Award.

The opportunity to learn and the required commitmentof time are substantial. The opportunity to learn includes

gaining a better understanding of the Baldrige Criteriaand seeing how they are used in high-performingorganizations, as well as developing a new networkof professional colleagues. The time commitment is aminimum of 114 hours from April to December (includ-ing approximately 40 hours in April/May to completeprework for the Examiner Preparation Course, 34 daysin May to attend the preparation course, and another5070 hours from June through September to completethe Independent and Consensus Reviews). If requestedby the Program, Examiners also are expected to partici-pate in the Site Visit Review (approximately 9 days).

Please note that all board appointments arefor one year only and that travel and housing

expenses incurred for the Examiner PreparationCourse must be covered by your organization.

To take advantage of this opportunity, an organi-zation must submit its Eligibility CertificationPackage (with a proof of the mailing date)on or before March 2, 2009. The EligibilityCertification Form can be found on pages 1423of this document, and Microsoft Word versionsof this form, as well as the Application Form,are available online atwww.baldrige.nist.gov/Award_Application.htm.


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Baldrige National Quality ProgramNational Institute of Standards and Technology Department of Commerce

Baldrige National Quality Program NIST Administration Building, Room A600 100 Bureau Drive, Stop 1020 Gaithersburg, MD 20899-1020

Telephone: (301) 975-2036 Fax: (301) 948-3716 E-mail: [email protected] Web site:www.baldrige.nist.gov

January 2009

Congratulations!

By supplementing your copy of the 20092010 Criteria for Performance Excellencewith acopy of the 2009 Baldrige Award Application Formsbooklet, you have taken the secondstep in using the Baldrige process to improve your organizations performance andgrowth. Now it is time to consider taking the next stepapplying for the Award.

For a nominal application fee, determined by the size and nature of your organization,your application will receive at least 300 hours of review by several experts selected fortheir depth and breadth of knowledge. Site-visited organizations receive more than1,000 hours of in-depth review, and each applicant receives an extensive feedback report.

Because of the learning inherent in completing the application and in the feedback youwill receive, the effort that goes into applying for the Award should result in a significantreturn on your investment. The process will help you prioritize opportunities forimprovement and identify strengths to celebrate. As a result, the rate at which yourorganization improves should accelerate.

To further increase your organizational learning, we will provide an opportunity for asenior employee of your organization to be a member of the 2009 Board of Examiners.If you are interested in taking advantage of this opportunity, you must submit yourEligibility Certification Form on or before March 2, 2009. You may use the forms in

this document or the Microsoft Word versions of these forms, which are available onlineatwww.baldrige.nist.gov/Award_Application.

Every Baldrige Award recipients journey toward performance excellence includes usingthe application process as part of the organizations improvement and strategic planningprocess. Many of our recipients apply several times before receiving the Award, whileothers receive the Award on their first attempt. They all report that the process is

worthwhile. The Baldrige process is designed to make each applicant a winner byraising its performance to a higher level. Consider making the decision to apply now,and accelerate the rate of your organizations performance improvement. As thousandsof organizations can attest, your organization will be better for it!

Sincerely yours,

Harry S. Hertz, DirectorBaldrige National Quality Program


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2009 Changes and Reminders

Text Format Requirements

The text format requirements for the applicationreport and supplemental sections have changedslightly. With the exception of some graphic elements(e.g., graphs and charts), all text mustbe in TimesNew Roman or Arial font and have a type size of 10points or larger. Narrow, condensed, or compressedfonts are not acceptable. Text in graphs and chartsmay be in any font, but the type size must be at least 8points. Failure to meet all the format requirementslisted on pages 29 and 30 of this document will resultin the rejection of your application. Should this occur,

you will be granted 72 hours after notification or untilthe original due date of the application (whichever islater) to reformat and resubmit it. Resubmittedapplications must be postmarked within that timeframe and mustbe shipped via overnight delivery.

Eligibility Expanded to Include Certain

Internal Suppliers

The Baldrige National Quality Program is institutinga simplification to the basic eligibility requirements.

This change permits a broader spectrum oforganizations to apply for the Award. Specifically,internal suppliers and support functions no longer areexcluded as long as the applicant organization consistsof at least 500 employees, staff members, and/orfaculty members and meets the other eligibility

requirements. Should a previous applicant be deemedineligible based on these changes, it will be granted atwo-year grace period during which it may participatein the Award process. See page 8 of this document formore information.

Proof of Mailing Date

The Eligibility Certification Package and the AwardApplication Package must each include a proof of themailing date. One option to fulfill this requirementis to send the packages via a delivery service (e.g.,

Airborne Express, Federal Express, United ParcelService, or United States Postal Service [USPS]Express Mail) that automatically records the mailingdate. If the packages are mailed through the USPS(via a service other than Express Mail), applicantsmust include a dated receipt from the post office inthe package. Applicants are encouraged to submit theEligibility Certification Package and the Award

Application Package early.

Opportunity to Nominate an Employee to

the Board of Examiners

In a change from previous years, nominations fromeligibility applicants for the Board of Examiners willbe accepted for first-time Examiner applicants only;

i.e., the person you nominate must not have servedpreviously as an Examiner for the Malcolm BaldrigeNational Quality Award. The travel-related expensesincurred as a result of a nominees participation in theExaminer Preparation Course must be covered by theindividual or his/her organization. See page 9 of theEligibility Certification Forms (page 22 in thisdocument) for more information.

Limits on the Number of Eligibility Applicants

Accepted

In future years, as the number of Award applicantscontinues to grow, the Program may need to limit thenumber of applications it can evaluate. Therefore,the Program is considering a first-come, first-servedapproach to accepting Eligibility CertificationPackages; those packages received after the specifiednumber (currently anticipated to be approximately110) is reached would not be accepted for that year.However, organizations whose packages were notaccepted for this reason would be guaranteed that, ifthey submitted an Eligibility Certification Package thefollowing year, it would be accepted.


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1 The Malcolm Baldrige National Quality Award and Award Process

3 2009 Baldrige Award Program Processes and Time Frames

5 Fees for the 2009 Award Cycle

6 2009 Eligibility Certification Overview

6 I. Purpose

6 II. Objective

6 III. Submission Requirements

6 IV. Eligibility Certification

6 V. Eligibility Categories

8 VI. Restrictions on Eligibility

10 2009 Eligibility Certification FormInstructions

14 2009 Eligibility Certification Form23 Submission of Forms and Mailing Address

24 2009 Eligibility Certification Package Checklist

26 North American Industry Classification System (NAICS) Codes

27 2009 Award Application PackageInstructions

27 I. Purpose

27 II. Objective

27 III. Content Requirements

28 IV. Application Report Components29 V. Format Requirements

30 VI. Assembly Requirements

31 VII. Submission Requirements

32 2009 Application FormInstructions

34 2009 Application Form

36 2009 Award Application Package Checklist

38 How to Obtain Copies of Baldrige National Quality Program Materials

40 The Quest for Excellence

XXI Conference40 Paperwork Reduction Act Statement

Contents

The Malcolm Baldrige National Quality Award logo and the phrases

The Quest for Excellence and Performance Excellence are trademarks

and service marks of the National Institute of Standards and Technology.


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What is the purpose of this booklet?

The purpose of this booklet is to provide instructionsand forms for (1) certifying eligibility to participate inthe Malcolm Baldrige National Quality Award processand (2) applying for the Award.

What is the Malcolm BaldrigeNational Quality Award?

The Malcolm Baldrige National Quality Award,created by Public Law 100-107 in 1987, is the highestlevel of national recognition for performanceexcellence that a U.S. organization can receive.

The major focus of the Award is on performance insix key areas: product and service outcomes, customer-focused outcomes, financial and market outcomes,

workforce-focused outcomes, process effectivenessoutcomes, and leadership outcomes. It is notgiven

for specific products or services. To be selected as anAward recipient, an organization must have a systemthat ensures continuous improvement in overallperformance in the delivery of products and/orservices and that provides an approach for satisfyingand responding to customers and stakeholders.

Up to 18 Awards may be given annually across sixeligibility categories: manufacturing, service, smallbusiness, education, health care, and nonprofit.Previous Award recipients that are nominated for asubsequent award will not be included in the totalcap of 18.

Why was the Award established?

The Award was established to promote the awarenessof performance excellence as an increasingly importantelement in competitiveness. Not only does the Awardrecognize organizations with exceptional performancestrategies, it also aims to increase the understandingof the requirements for performance excellence.

To accomplish this, the Award promotes informationsharing on successful performance strategies andthe benefits derived from using these strategies.

Who may participate?Organizations that may apply include privately andpublicly owned for-profit businesses and nonprofitorganizations headquartered in the United States andits territories; for-profit and nonprofit public, private,and government education organizations that provideeducation services to students in the United Statesand its territories; and for-profit and nonprofit public,private, and government health care organizations thatare located in the United States and its territories andare primarily engaged in providing medical, surgical,

or other health care services directly to people.Subunits and internal suppliers of organizations mayapply if they meet certain requirements.

Who is involved with the Award process?

National Institute of Standards and Technology:

The U.S. Department of Commerce is responsiblefor the Baldrige National Quality Program andthe Award. The National Institute of Standardsand Technology (NIST), an agency within theDepartment of Commerce, manages the Program.

American Society for Quality: Under contract toNIST, the American Society for Quality (ASQ)assists in administering the Award Program.

Board of Examiners:The Board of Examinersevaluates Award applications and prepares feedbackreports for the applicants. The board consists of

leading experts from U.S. businesses and healthcare, education, and nonprofit organizations.

Panel of Judges:This panel, which is part of theBoard of Examiners, selects Award applicants toundergo site visits and recommends Award recipients.

The Secretary of Commerce appoints the Judges,who are from all sectors of the U.S. economy.

Board of Overseers:This board is appointed bythe Secretary of Commerce and provides oversighton the Baldrige National Quality Program for theU.S. Department of Commerce. The board consists

of distinguished leaders from all sectors of theU.S. economy.

The Foundation for the Malcolm BaldrigeNational Quality Award:The Foundation raisesfunds to permanently endow the Award Programand manages the endowment.

How do the Criteria Categories for

Education and Health Care differ from the

Business/Nonprofit Criteria Categories?

There is a very close alignment among all three

Criteria and their related Categories. Six of the sevenCategories have the same title in all three Criteria.Variations on the title for Category 3, however, reflectdifferences in terminology among the three sectors:In the Criteria for Performance Excellence (referred toas the Business/Nonprofit Criteria), Category 3 iscalled Customer Focus. That same Category iscalled Student and Stakeholder Focus in theEducation Criteria for Performance Excellence andFocus on Patients and Other Customers in theHealth Care Criteria for Performance Excellence.

The Malcolm Baldrige National Quality Award and Award Process


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What is the basis for the Criteria?

The Criteria are developed from the learning ofprivate- and public-sector organizations that are

working to achieve organizational performanceexcellence. The Criteria reflect validated, leading-edge practices for achieving performance excellence.

How do applicants benefit from applying

for the Award?

Each applicant gains an outside perspective onits organization based on 300 to 1,000 hours ofreview by members of the Board of Examiners.

The results of this review are synthesized in afeedback report outlining strengths and opportunitiesfor improvement based on the Criteria. Feedbackreports are often used by organizations as part of theirstrategic planning process to focus on their customersand to improve results, as well as to help energizeand guide their organizational improvement efforts.

How are Award recipients selected?

Award applications are reviewed by a team fromthe Board of Examiners. The higher-scoringapplicants receive site visits. The Panel of Judgesreviews information obtained during these site

visits and, based on this review, recommends Awardrecipients from among the site-visited organizations.

The Secretary of Commerce then makes the finalselection of Award recipients.

What does an organization receive if it is

an Award recipient?

Each Award recipient receives a crystal trophybearing a gold-plated medallion with the inscriptionsMalcolm Baldrige National Quality Award andThe Quest for Excellence. The President of theUnited States traditionally presents the Award ata special ceremony in Washington, D.C. Awardrecipients may publicize and advertise their Awards.

Are the identity of applicants and the

information submitted made available

to the public?

The identity of all applicants remains confidentialunless the applicant is selected as an Award recipient.

The Baldrige Program treats all applicant infor-mation as strictly confidential and has numerousprotocols and processes in place to protect theapplicants and to help ensure the integrity of the

Award Program.

What is expected of Award recipients?

Award recipients are required to share informationabout their exceptional performance practices with

other U.S. organizations. However, recipients arenot required to share proprietary information,even if such information was part of their Awardapplication. The principal mechanisms for sharinginformation are the annual Quest for Excellence

Conference, highlighted on page 40 of this document,and several one-day regional conferences. Sharingbeyond The Quest for Excellence Conference is

voluntary.

How do organizations apply?

Applying for the Award is a two-part process.The first part is eligibility certification, whenthe organization certifies that it meets eligibilityrequirements. Instructions and the form forcertifying eligibility begin on page 10.

Eligibility Certification Packages will be acceptedbeginning January 1 (see due dates below).

The second part consists of preparing andcompleting an Award Application Package, including

an application form and an application report. Theapplication report must summarize the organizationspractices and results in response to the requirementsdelineated in the Items of the Criteria forPer-formance Excellence. Instructions and theform for applying for the Award begin on page 27.

Applications will not be accepted unless eligibilitycertification has been completed by the due date.

If you plan to apply for the Award in 2009,you also will need the appropriate 20092010Criteria for Performance Excellence booklet

(Business/Nonprofit, Education, or Health Care)for your particular organization. Orderinginformation is given on page 38.

Eligibility Certification Package with anomination to the Board of Examiners

due March 2, 2009

Eligibility Certification Package without anomination to the Board of Examiners

due April 7, 2009

Award Application Package submitted on aCD due May 7, 2009

Award Application Package submitted onpaper copies due May 21,2009


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2009 Baldrige Award Program Processes and Time Frames

Eligibility Certification(Package sent to ASQ with a proof ofthe mailing date byApril 7, 2009, OR

March 2, 2009, for eligibility certificationwith a nomination to the Board ofExaminers)

Award Application(Package sent to ASQ with a proofof the mailing date byMay 21, 2009,for paper copies ORMay 7, 2009,

if submitted on a CD)

Independent and Consensus Review(JuneSeptember 2009)

Site Visit Review(OctoberNovember 2009)

Judges Review(November 2009)

Prepare and submit the Eligibility Certification Package (with aproof of the mailing date) no later thanApril 7, 2009 (March 2,2009, for eligibility certification with a nomination to the Boardof Examiners) to certify eligibility in one of six Award categories:manufacturing, service, small business, education, health care,and nonprofit. Remember to indicate on the Eligibility Certification

Form your method of payment for the nonrefundable eligibilitycertification filing fee (see the box on page 5) and, if payingby check or money order, to include it in the EligibilityCertification Package.

Note: In the event of multiple submissions from one parent organization,while all may be found eligible, the number of applicants for the Awardwill be determined by eligibility restrictions under VI.C. Multiple-Application Restrictions on pages 89.

If submitting paper copies, prepare and submit 25 copies of theapplication report with the application fee(s) and a proof of themailing date no later thanMay 21, 2009. If the application reportis submitted on a CD, the package must be sent (with a proof of

the mailing date) byMay 7, 2009.The application fee (see thebox on page 5) covers expenses associated with the review ofapplications and the development of feedback reports. Indicate

your method of payment on the Application Form, and, if payingby check or money order, include it in the Award ApplicationPackage.

The application is reviewed independently by members of the Boardof Examiners. At the conclusion of this review, the application isreviewed jointly by a team of Examiners, led by a Senior Examiner.

At the conclusion of the latter review, the Panel of Judges deter-mines which applicants will receive site visits.

A team of six to eight members of the Board of Examiners, led bya Senior Examiner, conducts on-site verification and clarification ofthe application. Site visits consist primarily of a review of pertinentrecords and data, as well as interviews with senior leaders andemployees. Following the site visit, the Site Visit Team submitsits report to the Panel of Judges.

If an organization is chosen for a site visit, the organization isresponsible for paying a site visit fee, which helps cover expensesassociated with the site visit. More information on site visit feesis given on page 5. Additionally, the organization is expected toprovide updates for all results provided in the application.

These updates become part of the official application.

The Panel of Judges conducts final reviews and recommendsAward recipients to the Director of NIST, who conveys therecommendations to the Secretary of Commerce. The Secretaryof Commerce makes the final determination of Award recipients.

Role-Model Determination:The Secretary of Commerce and theDirector of NIST are responsible for determining that recom-mended Award recipients are appropriate role models and, there-fore, should be approved for the Malcolm Baldrige National Quality

Award. The purpose of this determination is to help ensure thepreservation of the Awards integrity.


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Feedback Reports(SeptemberDecember 2009)

Award Ceremony

(Spring 2010)

In determining role models, NIST conducts record checks onsite-visited applicants and the highest-ranking official to verifythat they are in compliance with legal and regulatory requirements.

This includes records of the Internal Revenue Service, the FederalBureau of Investigation, the Bureau of Export Administration,the General Services Administration, the Equal EmploymentOpportunity Commission, the Occupational Health and Safety

Administration, and local police and judicial offices in thejurisdiction of the applicants headquarters. No new or

independent investigations are conducted.Each applicant, including Award recipients, receives a feedbackreport. Feedback reports are prepared and distributed after it isdetermined either that the applicant will not move to the nextlevel of review for the Award or that the applicant is an Awardrecipient. Feedback reports are prepared by members of theBoard of Examiners based on applicants responses to theCriteria for Performance Excellence. The feedback reportscontain applicant-specific descriptions of strengths andopportunities for improvement based on the Criteria forPerformance Excellence.

The President of the United States traditionally presents the

Awards at a special ceremony in Washington, D.C.


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Fees for the 2009 Award Cycle

Eligibility Certification Filing Fee: For the 2009 Award cycle, a nonrefundable fee of $150 must be submitted to ASQ along with the Eligibility Certification Package and a proof of the mailing date no later than

April 7, 2009 (March 2, 2009, for eligibility certification with a nomination to the Board of Examiners).

Application Fee:The chart below shows the 2009 application fees for various types of organizations. For the2009 Award cycle, the appropriate fee must be submitted to ASQ with the Award Application Package and aproof of the mailing date no later thanMay 21, 2009, for paper copies (May 7, 2009, if submitted on a CD*).

AWARD CATEGORY ELIGIBILITY

FEE

APPLICATION

FEE*

SUPPLEMENTAL

SECTION FEE

(IF APPLICABLE)**

SITE VISIT FEE

USUAL RANGE

(IF APPLICABLE)***

MANUFACTURING $150 $7,000 $2,000 $20,000$35,000

SERVICE $150 $7,000 $2,000 $20,000$35,000

SMALL BUSINESS $150 $3,500 $1,000 $10,000$17,000

EDUCATION, NONPROFIT

K12$150 $1,250 $250 $1,500

EDUCATION, NONPROFIT

HIGHER EDUCATION$150 $3,500 $1,000 $10,000$17,000

EDUCATION, FOR-PROFIT

>500 FACULTY/STAFF

$150 $7,000 $2,000 $20,000$35,000

EDUCATION, FOR-PROFIT

500 OR FEWER FACULTY/STAFF$150 $3,500 $1,000 $10,000$17,000

HEALTH CARE

>500 STAFF$150 $7,000 $2,000 $20,000$35,000

HEALTH CARE

500 OR FEWER STAFF$150 $3,500 $1,000 $10,000$17,000

NONPROFIT

>500 STAFF$150 $7,000 $2,000 $20,000$35,000

NONPROFIT

500 OR FEWER STAFF$150 $3,500 $1,000 $10,000$17,000

*An additional processing fee of $1,250 is required for applications submitted on a CD.

**Supplemental sections are not applicable for applicants with (a) a single performance system that supportsall of their product and/or service lines and (b) products or services that are essentially similar in terms ofcustomers and/or users, technology, types of employees, and planning. For a description of a supplementalsection, see page 27.

***Site Visit Review FeeThis fee is paid only by applicants receiving site visits. The fee is set when visits are scheduled and is dependenton a number of factors, including the number of sites to be visited, the number of Examiners assigned, and theduration of the visit.

The site visit fee for applicants with more than 500 employees in the manufacturing, service, nonprofit, health

care, and for-profit education sectors usually ranges between $20,000 and $35,000. The site visit fee is approximately half that rate for small businesses, nonprofit higher education organizations, and applicants in the healthcare, for-profit education, and nonprofit sectors with 500 or fewer employees. In 2009, the site visit fee fornonprofit K12 education organizations is $1,500. The site visit fee for all organizations is due to ASQ two

weeks after completion of the site visit.Note: The Program anticipates a rise in fees in the 2010 Award cycle, as well as possible increases thereafter.Such increases would be based on related changes in the Consumer Price Index.

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I. Purpose

The purpose of this section is to provideapplicants with information on the eligibilitycertification process, which is the first step inapplying for the Malcolm Baldrige NationalQuality Award. This information describes theeligibility categories and eligibility restrictionsand then provides step-by-step instructions onhow to complete the Eligibility CertificationForm and other portions of the EligibilityCertification Package.

II. Objective

The objective of the Eligibility CertificationPackage is to provide sufficient information todetermine whether the organization is eligible toapply for the Award. In addition, the EligibilityCertification Form presents a useful profile of the

organization and often is the first informationabout the applicant read by Examiners. Theinformation also is used by the Baldrige NationalQuality Program Office to avoid conflicts ofinterest when assigning applications to Examiners.

Applicants self-certify their eligibility to partic-ipate in the Award process. The role of theBaldrige Office in the self-certification process isto assist with and offer advice on any questions orissues that applicants may have concerning theprocess itself or the completion of the requiredforms included in this document. Notification of

eligibility by the Baldrige Office is not required tobegin preparation of the application; however,applications will not be accepted unless theEligibility Certification Package has beensubmitted by the due date.

The Baldrige Office relies on the informationsubmitted in the Eligibility CertificationForm. If at any time during the Award cycle theinformation is found to be inaccurate, deemingthe applicant ineligible, the Baldrige Office mayremove the applicant from Award eligibility. Shouldthis occur, the applicant would be eligible for a

feedback report only.

III. Submission Requirements

A. Eligibility Certification Package

The Eligibility Certification Package consistsof the following materials. All informationprovided is considered confidential.

1. A completed Eligibility Certification Formmust be signed by the highest-rankingofficial of the organization.

2.An organization chart(s) and otherrequired documents described in theEligibility Certification FormInstructionson pages 1013 must be included.

3. FeeThe method of payment for the $150

nonrefundable fee must be indicated on theEligibility Certification Form. Payments bycheck or money order must be made payableto theMalcolm Baldrige National Quality

Award and included in the EligibilityCertification Package.

B. Submission

Potential applicants for the 2009 Awardare encouraged to submit the EligibilityCertification Package to ASQ as early aspossible.The package must be mailed nolater than April 7, 2009 (March 2, 2009, for

eligibility certification with a nominationto the Board of Examiners). See page 25for ASQs address. In addition, theEligibility Certification Package mustinclude a proof of the mailing date. Oneoption to fulfill this requirement is tosend the package via a delivery service (e.g.,

Airborne Express, Federal Express, UnitedParcel Service, or the United StatesPostal Service [USPS] Express Mail) thatautomatically records the mailing date. If thepackage is mailed through the USPS (via aservice other than Express Mail), applicants

must include a dated receipt from the postoffice in the package.

IV. Eligibility Certification

The Eligibility Certification Package will bereviewed promptly. If clarification is required, thedesignated Eligibility Contact Point or alternate

will be contacted.

V. Eligibility Categories

A. Business

Any for-profit business headquartered in theUnited States or its territories, including U.S.subunits of foreign companies, may apply forthe Award. For-profit businesses includedomestic or foreign-owned companies, joint

ventures, corporations, sole proprietorships,partnerships, and holding companiespubliclyor privately owned.

The three business categories are definedas follows:

2009 Eligibility Certification Overview


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1.Manufacturing Organizations and some subunits (see VI.

Restrictions on Eligibility, Part B onpage 8) that produce and sell manu-factured products or manufacturingprocesses.

Companies that produce agricultural,mining, or construction products. (SeeNorth American Industry ClassificationSystem [NAICS] codes on page 26.)

2. Service

Organizations and some subunits thatprovide or sell services.

Note: If an applicant is both a manufacturer and aservice provider, the appropriate eligibility categoryis the activity that provides the larger percentageof sales.

3. Small Business

Organizations with 500 or fewerpaid employees that are engaged inmanufacturing and/or the provision ofservices and that are discrete, independententities.

B. Education

Participation is open to for-profit andnonprofit public, private, and governmentorganizations and some subunitsincludingU.S. subunits of foreign organizationsthatprovide education (teaching and instructional)services to students in the United States or its

territories. Eligibility is intended to be as openas possible. For example, eligible organizationsinclude elementary and secondary schools andschool districts; colleges, universities, anduniversity systems; schools or colleges withinuniversities; professional schools; communitycolleges; and technical schools. More than 50percent of all faculty and staff members and/orthe budget must be devoted to providingteaching/instructional services directlyto students.

Departments within schools or colleges are

ineligible.

Note: Education organizations may choose to applyunder the service, small business, or nonprofitcategories, as appropriate, using the Business/Nonprofit Criteria, or under the education category,using the Education Criteria.

C. Health Care

Participation is open to for-profit andnonprofit public, private, and government

organizations and some subunitsincludingU.S. subunits of foreign organizationslocated in the United States or its territories.

These organizations must be engagedprimarily in providing medical, surgical, orother health care services directly to people.

More than 50 percent of all staff membersand/or the budget must be devoted toproviding health care services directly topeople. Eligibility is intended to be as open aspossible. For example, eligible organizationsinclude hospitals, health maintenanceorganizations, long-term care facilities, healthcare practitioners offices, home healthagencies, and dialysis and ambulatory surgerycenters.

Organizations that do not provide healthservices directly to people, such as socialservice agencies, health insurance companies,or medical/dental laboratories, are ineligibleunder this category. However, such orga-nizations might be eligible under the service,small business, or nonprofit category, asappropriate.

Note: Health care organizations may choose toapply under the service, small business, or nonprofitcategory, as appropriate, using the Business/Nonprofit Criteria, or under the health carecategory, using the Health Care Criteria. Whenan applicant is both an education organizationand a provider of health care services to people, theappropriate eligibility category is the activity thatrepresents the larger percentage of its budget.

D.Nonprofit

Participation is open to U.S.-based nonprofitpublic, private, and government organizationsand some subunitsincluding U.S. subunits offoreign organizationslocated in the UnitedStates or its territories. Eligibility is intendedto be as open as possible. For example, eligibleorganizations include local, state, and federalgovernment agencies; trade associations;charitable organizations; social serviceagencies; credit unions; and professionalsocieties.

Note: The U.S. Department of Commerce, theAmerican Society for Quality (ASQ), and theirsubunits are not eligible to apply for the BaldrigeAward.

Note: When a nonprofit organization provideseducation (teaching and instructional) servicesdirectly to students or health care services directlyto people in addition to other nonprofit services,the appropriate eligibility category is the activitythat represents the larger percentage of its budget.


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For example, if a state department of educationallocates 70 percent of its budget to overseeing thecertification of teachers and educational programsand 30 percent to providing education servicesdirectly to students, the nonprofit category wouldbe the appropriate one.

VI. Restrictions on Eligibility

The following restrictions and conditions ensure

fairness and consistency.A. Conditions

1. The applicant must have been in existenceprior to April 7, 2008.

2. All subordinate elements of the applicantsorganization must be included in theapplication.

3. An applicant is eligible only if the opera-tional practices associated with all of itsmajor organizational functions can beexamined in the United States or its terri-

tories. For eligibility purposes, overseasU.S. military installations and embassies donot constitute U.S. territories. If some of anapplicants activities are performed outsideits immediate organization (e.g., by overseascomponents, a parent organization, or othersubunits), it must ensure that

in the event of a site visit, the appro-priate personnel and materials will beavailable for examination in the UnitedStates to document operational prac-tices in all major organizational

functions; and in the event the applicant receives

the Award, the applicant will beable to share information on theseven Criteria Categories at TheQuest for Excellence Conferenceand at its U.S. facilities. Sharingbeyond The Quest for ExcellenceConference is voluntary.

B. Subunits

For the purposes of the 2009 Award Applica-tion, a subunit means a unit or division of alarger organization. The larger organizationthat owns, holds, or has organizational orfinancial control of a subunit will be referredto as the parent. A parent is the highest levelof an organization that would be eligible toapply for the Award.

Note: In the nonprofit category, examples ofparent organizations are the U.S. Departmentof Defense (not the Department of the Army),

the State of Maryland (not the Department ofTransportation), and the Montgomery CountyGovernment (not the Montgomery CountyHealth Department).

The following requirements pertain tosubunits:

1. A subunit must be self-sufficient enough tobe examined in all seven Criteria Categories.

2. A subunit must have a clear definition oforganization as reflected in organizationliterature, such as organization charts,administrative manuals, and annual reports;be recognizable as a discrete entity; and beeasily distinguishable from the parent orother subunits of the parent.

3. The subunit must function as a business oroperational entity, not as a collection ofactivities aggregated for the purposes of

writing an Award application.

4. To be eligible for the Award, a subunit must

have 500 or more employees or meet thefollowing criteria: subunits that have fewerthan 500 employees and that do not qualifyas a small business (see 5 below) must haveat least 25% of the parent organizationstotal number of employees and sell/provide50 percent or more of their products orservices outside their organization, theparent organization, and other organizationsthat own or have financial or organizationalcontrol of the applicant or parent.

5. Manufacturing and service subunits that

have fewer than 500 employees and do notmeet these criteria should apply in the smallbusiness category if

the applicant subunit was independentprior to being acquired by theparent and continues to operateindependently under its own identity,OR

the applicant subunit is separatelyincorporated and distinct from othersubunits of the parent.

6. These subunit requirements may not applyto some health care and education subunits.For more information, see Section V.Eligibility Categories.

C. Multiple-Application Restrictions

1. A subunit and its parent may submitEligibility Certification Packages in thesame year but may not apply for the

Award in the same year.


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2. All subunits of a parent may submitEligibility Certification Packages; however,there are restrictions on the number ofsubunits that may apply for the Award inthe same year. If the parent organization,including all of its subunits, has

01,000 employees, one applicant perparent per category may submit an

Award Application Package;

1,00120,000 employees, two applicantsper parent per category may submit an

Award Application Package; or

more than 20,000 employees, twoapplicants per parent per category forthe first 20,000, plus one per 20,000 orfraction thereof above 20,000 per parentper category, may submit an Award

Application Package.

No more than five applicants (all Awardcategories combined) per parent will be

accepted.3. In the event of multiple submissions for the

Award from subunits of the same parentbeyond the limits noted in VI.C.2 above, theparent organization will be given the optionof deciding which subunit(s) will representit in the Award process. Alternatively, if theparent organization does not choose repre-sentative subunits, the applications with theearliest mailing date (as indicated by theproof of the mailing date) will be designatedthe applicants for the Award.

D.Restrictions on Award Recipients

If an organization or a subunit that has morethan 50 percent of the total employees of theparent receives an Award, the organization andall its subunits are ineligible to apply foranother Award for a period of five years. If asubunit receives an Award, that subunit and allits subunits are ineligible to apply for another

Award for a period of five years. For example,an applicant that received the Award in 2007may not reapply until 2013.

After five years, Award recipients are eligible toreapply for the Award or to apply for feedbackonly. If a former Award recipient selects theoption to apply for feedback only (see items 5cand 5d on the 2009 Eligibility CertificationForm, page 15), the organization will not beeligible to receive the Award for that year. Itsapplication will proceed through the Awardprocess, but the applicant will receive only a

feedback report outlining its strengths andopportunities for improvement based on theCriteria for Performance Excellence.


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1. Applicant

Provide the applicants official (legal) name,which will be used to make the role-modeldetermination. (See pages 34.) Also, provideany other names by which the applicant may beknown publicly (doing-business-as) and its priorname if there has been a name change withinthe last five years. Provide the address of theapplicants headquarters.

2. Highest-Ranking Official

Provide the necessary contact informationrequested for the applicants highest-rankingofficial.

3. Eligibility Contact Point

After the receipt of the 2009 Eligibility

Certification Form and associated materials,it may be necessary to contact the applicant foradditional information. Please designate a person

who is knowledgeable about the organization andits structure and who will be available to answerinquiries during the month following submissionof the Eligibility Certification Form.

4. Alternate Eligibility Contact Point

In the event that the Eligibility Contact Pointis not available, an Alternate Eligibility ContactPoint will be needed to answer questions or

convey a message to the Eligibility Contact Point.Designate a person who will be available duringthe month following submission of the EligibilityCertification Form.

5. Applicant History

a. Indicate if your organization has submitted anEligibility Certification Package in prior yearsand, if so, when it was submitted and the nameof the organization at that time, if it wasdifferent.

b. Indicate whether or not the applicant has

existed for at least one year, or prior toApril 7, 2008.

c. Indicate whether or not the applicant has everbeen a Malcolm Baldrige National Quality

Award recipient. If you check No, proceedto item 5e.

d. Indicate whether your organization was anAward recipient in 2003 or earlier. If youcheck No, your organization is not eligibleto reapply this year for the Award or forfeedback. If you check Yes, indicate whether

you are applying for feedback only or for theAward by checking the appropriate response.

e. Indicate whether your organization hasparticipated in a state or local Baldrige-basedaward program, and if so, what years.

Note: A response to this question is optional;responses will be used for research purposes only andare not a factor in your eligibility or the evaluationof your application.

6. Award Category and For-Profit/NonprofitDesignation

Based on the information given on pages 68 ofthis document, indicate which of the six Awardcategories is appropriate and which of thethree Criteria booklets (Criteria for PerformanceExcellence [for use by businesses and nonprofit

organizations], Education Criteria for PerformanceExcellence, orHealth Care Criteria for PerformanceExcellence)will be used to prepare the application.Also indicate whether the applicant is a for-profitor nonprofit organization.

Industrial Classifications:

Using the three- or four-digit NAICS codes listedon page 26, provide up to three codes that bestdescribe the applicants products and/or services.

7. Applicants Organizational Structure

a. Provide the current total number of paidemployees (including paid faculty and staffmembers, as appropriate). Do not includeunpaid volunteers.

b. Check the appropriate financial descriptor(sales, revenues, or budgets) and theappropriate range for the preceding fiscal year.

c. Indicate the number of the applicantorganizations sites. Offices or other workareas located near each other need not becounted as separate sites if they are consideredto be one location for business and personnel

purposes. (This information should align withyour response to item 13, Site Listing andDescriptors.)

d. State the approximate percentage (to thenearest whole number) of the applicantsemployees who are located in and outsidethe United States or its territories.

e. State the approximate percentage (to thenearest whole number) of the applicantsphysical assets located in and outside theUnited States or its territories.

2009 Eligibility Certification FormInstructions


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f. Attach a line-and-box organization chart forthe applicant that includes the division or unitlevel. In each box, include the name of the unitor division and the name of its leader. Pleasedo not use colors or shading, as these canobliterate textual information when thedocument is copied.

g. Check all that apply. Unless you havechecked not applicable, provide the name

and address of the parent (the highest levelof an organization eligible to apply for theAward) and the name and title of the highest-ranking official of the parent. Provide thenumber of worldwide employees of the parent,including all subunits. Do not include joint

ventures of the parent. See Section VI.B of theEligibility Certification Overview (page 8) formore information on subunits and parents.

h. Check the appropriate response. If two ormore subunits from the parent are planningto apply for the Award, provide a briefexplanation.

i. Attach a line-and-box organization chart(s)showing the relationship of the applicant tothe highest management level of the parent,including all intervening levels. In each box,include the name of the leader of the unit ordivision. Please do not use shading or colorin the boxes.

j. In reference to this line-and-box organizationchart, brieflydescribe how your organizationrelates to the parent organization and othersubunits of the parent in terms of products,services, and management structure.

k. Provide the name and date, as well as a copy ofrelevant portions, of an official document thatshows a clear definition of the applicant as adiscrete entity.

Note: Applicants supplying a Web site as documentationto support their status as a subunit must print out therelevant Web pages and submit these in their EligibilityCertification Package.

l. Briefly describe the major functions providedto the applicant by the parent or by othersubunits of the parent.

8. Eligibility Determination Questions

Questions for all applicants:All applicants mustprovide responses to questions a, b, c, and d.

a. Check the appropriate response. In order tobe eligible, the applicant organization itselfmust be headquartered in the United States.If you have a parent organization that isheadquartered outside of the United States,it will notautomatically disqualify youfrom consideration.

b. Check the appropriate response.

c. Check the appropriate response.

d. Check the appropriate response to indicatethe applicants ability to respond to all sevenBaldrige Criteria Categories. This questionfocuses on whether the applicant organizationhas processesand related resultsfor theorganizations unique operations, products,and/or services. For example, does the

applicant have an independent leadershipsystem to set and deploy the organizations

vision and values, as well as its strategy andaction plans? Has it implemented processesfor engaging customers and the workforce,as well as for tracking and using data onthe effectiveness of these approaches?

Note: If you checked No for question a, b, c, or d,contact the Baldrige Office at (800) 898-4506.

Questions for subunits: Only organizations thatare subunits of a larger (parent) organization

should respond to questions e, f, g, and h.e. Check the appropriate response for the first

question. If you checked No, check theappropriate response for the two subsequentquestions. To be eligible for the Award, subunitorganizations that have fewer than 500 paidemployees, staff, and/or faculty and that do notqualify as a small business (see questions g andh) must have at least 25 percent of the parentorganizations total number of employeesand sell/provide 50 percent or more of theirproducts or services outside their organization,the parent organization, and otherorganizations that own or have financial ororganizational control of the applicant orparent.

f. Check the appropriate response. If you checkedNo, (1) provide a brief description of how themarket and product(s) or service(s) are similar;(2) indicate the organizational relationshipsof all units that provide similar or identicalproducts or services, including the approximatesales, revenues, or budgets for each; and (3)describe how the applicant is different fromits parent and the other subunits of the

organization (e.g., differences in market,location, or name).

g. Check the appropriate response.

h. Check the appropriate response.

If you checked No for all parts of e, as wellas f, g, and h, contact the Baldrige Office at(800) 898-4506.

If you checked No for the first question under e

(more than 500 paid staff/faculty/employees) and


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also checked Yes for the second and thirdquestions under e,

your organization may be eligible as a subunit.

If you checked No for the first question under e,

also checked No for either or both of the secondand third questions under e, and

also checked Yes for either g or h, yourorganization may be eligible in the small businesscategory.

Note: If self-certification is based on the subunitbeing independent prior to being acquired andcontinuing to operate independently under itsown identity, provide a copy of an officialdocument to support this response.

Note: If self-certification is based on the subunitbeing separately incorporated and distinct fromother subunits of the parent, provide a copy of anofficial document (e.g., articles of incorporation)to support this response.

9. Supplemental Sections

Check the appropriate response (only one). If thesecond option is selected, the Eligibility ContactPoint will be contacted. Applicants may havetwo or more business units with diverse productand/or service lines (i.e., in different NAICScodes) with customers, workforce or employeetypes, technology, planning, and quality systemsthat are so different that the application reportalone does not allow sufficient detail for a fairexamination. Such applicants may submit one or

more supplemental sections (see page 27 of thisdocument) in addition to the application report.The use of supplemental sections must beapproved during the eligibility certificationprocess and is mandatory once approved.

10. Application Format

Indicate if your organization intends to submit itsapplication on (1) 25 paper copies (due date May21, 2009) or (2) a CD (due date May 7, 2009).

11. Confidentiality Considerations

Check Yes if you authorize Examiners to usecell phones, cordless phones, and Voice overInternet Protocol (VoIP) to discuss yourapplication. Check No if you do not wishExaminers to use these technologies during theevaluation process. Examiners hold all applicantinformation in strict confidence and will discuss

your application only with other Examinersassigned to evaluate the application and Programrepresentatives on an as-needed basis.

12. Self-Certification Statement, Signatureof the Highest-Ranking Official

Provide the signature of the applicants highest-ranking official, as well as the date. This signatureacknowledges that the answers provided areaccurate and also certifies that the applicant iseligible based on the requirements for the 2009

Malcolm Baldrige National Quality Award. Ifthe applicants organization is selected for a site

visit and it is discovered that one or more of theresponses in the Eligibility Certification Form areinaccurate, the applicant will no longer be eligiblefor the Award. However, the applicant will beeligible for feedback on its organization.

13. Site Listing and Descriptors

Provide the complete address of each site. Incases where many sites perform the same function,aggregate the sites under one listing and make asummary statement about the locations insteadof listing an address for each one. If a site visit

is conducted, a more detailed listing will berequested when the visit is planned. If theapplicant has foreign sites, these sites mustbe included on the form. Duplicate the SiteListing and Descriptors page or attach a similarlyformatted document if all sites cannot be listedon a single page. The application report mustaddress activities in foreign sites in the appropriateItems. Although no site visits will be conductedat facilities outside the United States or itsterritories, these facilities may be contactedby teleconference or video conference.

Check the appropriate type(s) of workforcemembers (employees, faculty, and/or staff).Some organizations may have both faculty andstaff. Provide the number and type of workforcemembers at each site. See the example onpage 7 of the Eligibility Certification Form.

Check the appropriate financial descriptor(sales, revenues, or budgets). Provide theapproximate percentage of sales, revenues, orbudgets accounted for by the output of eachsite (if a percentage of sales or revenues is notappropriate for a particular site(s), use N/A[not applicable]).

14. Key Business/Organization Factors

Provide the following information, limiting youranswers to a single page. This information is usedto help avoid any real or perceived conflicts ofinterest with your organization and the Examinersassigned to your application.

For the purposes of the 2009 Award Application, keymeans those organizations that constitute 5 percent ormore of the applicants competitors, customers/users, orsuppliers/partners.


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a. Description of the applicants main productsand/or services and of the major markets served(local, regional, national, and international)

b. List of key competitors

c. List of key customers/users

d. List of key suppliers/partners

e. The name of the organizations financial auditor

f. The applicants fiscal year (e.g., October1September 30)

15. Nomination to the Board of Examiners

If your organization would like the opportunity togain a deeper insight into the Baldrige Criteria forPerformance Excellence and the Baldrige Awardprocess, you may nominate a senior memberof your organization to be noncompetitivelyappointed to the Board of Examiners.

The nominee must not have served previously asan Examiner for the Malcolm Baldrige NationalQuality Award.

The nominee will be expected to fully participateas a member of the board; this includes attendingthe Examiner Preparation Course in Gaithersburg,

Maryland, and participating in the evaluation ofan organization that has applied for the Award.

All board appointments are for one year only.

Please note: Travel and housing expenses incurredby your nominee for the Examiner PreparationCourse must be covered by the individual or his/herorganization. These expenses will not be reimbursed by

the Program. In addition, if your organization alreadyhas representatives on the Board of Examiners,nominating an additional person may impact thecompetitive selection of the existing representatives ofyour organization for another term, as the Programlimits the number of Examiners it selects from anyparticular organization.

If you wish to nominate a senior member of yourorganization to the Board of Examiners, providethe requested information with your EligibilityCertification Package (with a proof of the mailingdate) on or before March 2, 2009.

16. Eligibility Certification Filing Fee

Provide payment for the $150 nonrefundable feeto cover the cost of the eligibility filing process.Check the appropriate box to indicate whichmethod of payment will be provided (check,

money order, American Clearing House [ACH]payment, wire transfer, Visa, MasterCard, or

American Express).

Check or money orderPlease make your check or money order payableto theMalcolm Baldrige National Quality

Award.

Send the check or money order with thecompleted Eligibility Certification Package to

Malcolm Baldrige National Quality Awardc/o ASQ600 North Plankinton Avenue

Milwaukee, WI 53203

ACH payment or wire transferChecking American Bankers Association (ABA)routing number: 075-000-022Checking account number: 182322730397

Please reference the Malcolm Baldrige National

Quality Award with your payment.ASQ must benotified either by phone at (414) 298-8789,ext. 7205, or e-mail at [email protected] beforean ACH payment or wire transfer is sent.

Visa, MasterCard, or American ExpressFill in the information requested (credit cardnumber, expiration date, printed name andsignature of the card holder, billing address, anddate signed).

W-9 RequestIf you require an Internal Revenue Service (IRS)

W-9 Form (Request for Taxpayer IdentificationNumber and Certification), please contact ASQat (414) 298-8789, ext. 7205.

17. Submission of Eligibility Forms

The 2009 Eligibility Certification Package mustbe submitted with a proof of mailing no later than

April 7, 2009 (on or before March 2, 2009, if youinclude a nomination to the Board of Examiners).One option to fulfill the proof of mailing require-ment is to send the package via a delivery service(e.g., Airborne Express, Federal Express, United

Parcel Service, or the United States Postal Service[USPS] Express Mail) that automatically recordsthe mailing date. If the package is mailed throughthe USPS (via a service other than Express Mail),applicants must include a dated receipt from thepost office in the package.

Remember to indicate the method of payment for the eligibility certification filing fee on the EligibilityCertification Form. If paying by check or money order, include it with the completed EligibilityCertification Form in your Eligibility Certification Package.


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2009 Eligibility Certification Form P a g e 1 o f 1 0Malcolm Baldrige National Quality Award

1. Applicant

Official Name Headquarters Address_______________________________________________ _________________________________________________

Other Name_______________________________________________ _________________________________________________

Prior Name_______________________________________________ _________________________________________________

2. Highest-Ranking Official

Mr. Mrs. Ms. Dr.

Name Address_______________________________________________ _________________________________________________

Title_______________________________________________ _________________________________________________

Telephone No._______________________________________________ _________________________________________________

E-Mail Fax No._______________________________________________ _________________________________________________

3. Eligibility Contact PointMr. Mrs. Ms. Dr.

Name Address_______________________________________________ _________________________________________________

Title_______________________________________________ _________________________________________________

Telephone No. Overnight Mailing Address (Do not use a P.O. Box number.)_______________________________________________ _________________________________________________

Fax No._______________________________________________ _________________________________________________

E-Mail_______________________________________________ _________________________________________________

4. Alternate Eligibility Contact Point

Mr. Mrs. Ms. Dr.

Name__________________________________________________________________________________________________________

Telephone No.__________________________________________________________________________________________________________

Fax No.__________________________________________________________________________________________________________

5. Applicant History

a. Has the applicant self-certified for eligibility in a prior year(s)?

Yes No Do Not Know

If Yes, indicate the year(s) in which the applicant submitted the Eligibility Certification Package and the

name(s) of the applicant at that time, if different.

Year(s)__________________________________________________________________________________________________________

Name(s) of Applicant__________________________________________________________________________________________________________

b. Has the applicant officially or legally existed for at least one year, or prior to April 7, 2008?

Yes No

OMB Clearance #0693-0006

Expiration Date: April 30, 2010

If you are unable to respond to any item,please contact the Baldrige National Quality Program Office at (800) 898-4506 before submitting your form.


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Malcolm Baldrige National Quality Award

2009 Eligibility Certification Form P a g e 2 o f 1 05. Applicant Historycontinued

c. Has your organization ever been a Malcolm Baldrige National Quality Award recipient?

Yes No

If you checked No, proceed to item 5e.d. If Yes, was your organization an Award recipient in 2003 or earlier?

Yes No

If you checked No, your organization is not eligible to reapply this year for the Award or for feedback(please contact the Baldrige National Quality Program Office at [800] 898-4506 if you have any questions).If you checked Yes, please choose one of the following options:

Applying for feedback only Applying for the Malcolm Baldrige National Quality Award

e. Has your organization participated in a state or local Baldrige-based quality award process? (Optional)

Yes No

If you checked yes, please list the years your organization was involved.

6. Award Category and For-Profit/Nonprofit Designation (Check one.)

Manufacturing (For-Profit Only) Nonprofit Health Care (For-Profit)

Service (For-Profit Only) Education (For-Profit) Health Care (Nonprofit)

Small Business: 500 Employees Education (Nonprofit)(For-Profit Only)

Note: For more information on these eligibility categories, see pages 68 of the Baldrige Award Application Forms.Criteria booklet being used: (Check one.)

Criteria for Performance Excellence (for use by businesses and nonprofit organizations)

Education Criteria for Performance Excellence Health Care Criteria for Performance Excellence

Note: Education and health care organizations may choose to use the Criteria for Performance Excellence and apply in theservice, small business, or nonprofit categories. However, they probably will find their sector-specific Criteria (EducationCriteria for Performance Excellence orHealth Care Criteria for Performance Excellence) more appropriate.

Industrial classifications: List up to three of the most descriptive three- or four-digit NAICS codes. These areused to better identify your organizational functions and for assigning applications to Examiners. (For a list of theNAICS codes, see page 26 of the Baldrige Award Application Forms.)

7. Applicants Organizational Structure

a. Total number of employees, including paid staff/faculty: ______ people

b. For the preceding fiscal year, check one financial descriptor: Sales Revenues Budgets

check the range: 0$1M $1M$10M $10M$100M $100M$500M

$500M$1B More than $1B



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7. Applicants Organizational Structurecontinued

c. Number of sites: U.S./Territories _____ Outside U.S./Territories _______

d. Percentage of employees: U.S./Territories _____ Outside U.S./Territories _______

e. Percentage of physical assets: U.S./Territories _____ Outside U.S./Territories _______

f. Attach a line-and-box organization chart for the applicant that includes divisions or unit levels. In each box,include the name of the unit or division and the name of its leader. Please do not use shading or color in theboxes. (For more guidance, see page 11 of the Baldrige Award Application Forms.)

g. The applicant is _____ a larger parent or system? (Check one)

a subsidiary of controlled by administered by owned by a division of a unit of a school of not applicable

If you checked not applicable, please proceed to item 8. Otherwise, provide the following information and then

continue to item 7h.

Parent Organization* Highest-Ranking Official

Name: Name:

Address: Title:

Total worldwide number of employees/faculty/staff of the parent:

*Parent means the highest organizational level eligible to apply for the award. For more information, see page 8of the Baldrige Award Application Forms.

h. Is the applicant the only subunit of the parent organization intending to apply?

Yes No (Briefly explain.) Do Not Know

i. Attach a line-and-box organization chart(s) showing the relationship of the applicant to the highestmanagement level of the parent, including all intervening levels. Each box within the chart should includethe name of the leader of the unit or division. Please do not use shading or color in the boxes.(See page 11 of the Baldrige Award Application Forms.)

j. Considering the above line-and-box organization chart, briefly describe how your organization relates to theparent organization and other subunits of the parent in terms of products, services, and management structure.

k. Provide the name and date of the official document (e.g., an annual report, organization literature, a pressrelease) showing a clear definition of the applicant as a discrete entity. Attach a copy of relevant portionsof the document only.

Note: Applicants supplying a Web site as documentation must print the relevant pages and include these intheir Eligibility Certification Package.

Name of the Document __________________________________________ Date ______________________




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2009 Eligibility Certification Form P a g e 4 o f 1 0


l. Briefly describe the major functions provided to the applicant by the parent or by other subunits of theparent, if appropriate. (Examples of such functions include, but are not limited to, strategic planning, businessacquisition, research and development, facilities management, data gathering and analysis, human resource services,legal services, finance or accounting, sales/marketing, supply chain management, global expansion, information andknowledge management, education/training programs, information systems and technology services, curriculum and

instruction, and academic program coordination/development.)

8. Eligibility Determination Questions

Eligibility for the Baldrige Award is intended to be as open as possible while ensuring that potential Awardrecipients are viable role models for other organizations on their performance excellence journey. Your answersto the following questions will help determine your organizations eligibility to apply for the Award. Moreinformation is available on pages 89 and 1112 of the Baldrige Award Application Forms.

Questions for All Applicantsa. Is the applicant organization a distinct organization or business unit headquartered in the United States?

Yes No (Briefly explain.)

b. Operational practices associated with all major organizational functions must be accessible for examination inthe United States. If some activities are performed outside the applicants organization (i.e., by a componentof the applicant that is outside the United States or its territories, the parent organization, or its othersubunits), will the applicant, if selected for a site visit, make available in the United States sufficientpersonnel, documentation, and facilities to allow full examination of its operational practices for all majorfunctions of its worldwide operations?

Yes No

c. In the event the applicant receives an Award, can the applicant make available sufficient personnel anddocumentation to share its practices at The Quest for Excellence Conference and at its U.S. facilities?

Yes No

d. Is the applicant able to respond to all seven Baldrige Criteria Categories? (This question focuses on whetherthe applicant organization has processesand related resultsfor the organizations unique operations,products, and/or services. For example, does the applicant have an independent leadership system to setand deploy the organizations vision and values, as well as its strategy and action plans? Has it implementedprocesses for engaging customers and the workforce, as well as for tracking and using data on theeffectiveness of these approaches?)

Yes No

If you checked No forany of the above questions ( a, b, c, or d), contact the Baldrige Office at (800) 898-4506.

Questions for Subunits Onlye. Does the applicant have more than 500 paid staff/faculty/employees? (Check one.)

Yes No

If No, please answer both of the following questions:

Does the applicant have more than 25 percent of the employee base of the parent organization?Yes No


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Are 50 percent or more of the applicants products or services sold or provided directly to customers/usersoutside the applicants organization, its parent organization, and other organizations that own or havefinancial or organizational control of the applicant or parent?

Yes No

f. Is the applicant recognizably different from its parent and the other subunits of the organization? (Forexample, do the applicants customers distinguish its products and services from those of the parent and/orother subunits? Are the applicants products or services unique within the parent organization? Do otherunits within the parent provide the same products or services to a different customer base?)

Yes No (Briefly explain.)

g. Is the applicant separately incorporated and distinct from other subunits of the parent?

Yes No

If self-certification is based on the subunit being separately incorporated and distinct from other subunits ofthe parent, attach relevant portions of an official document (e.g., articles of incorporation) to support thisresponse.

h. Was the applicant independent prior to being acquired by the parent, and does it continue to operateindependently under its own identity?

Yes No

If self-certification is based on the subunit being independent prior to being acquired and continuing to operateindependently under its own identity, attach relevant portions of an official document to support this response.

Your responses to e through h may affect your eligibility as summarized below:

18



IF

You checked No for all parts of e, as well as f, g,and h

You checked No for the first question under e(more than 500 paid staff/faculty/employees, andyou also checked Yes for the second and thirdquestions under e

You checked No for the first question under e,you also checked No for either or both of thesecond and third questions under e,ANDyou also checked Yes for either g or h

THEN

...your organization probably is not eligible for the Award;please contact the Baldrige Office at (800) 898-4506.

...your organization may be eligible as a subunit.

...your organization may be eligible in the small businesscategory.

8. Eligibility Determination Questionscontinued


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2009 Eligibility Certification Form P a g e 6 o f 1 0Signature of Highest-Ranking Official

Printed Name

Date


9. Supplemental Sections (Check one.)

The applicant has (a) a single performance system that supports all of its product and/or service lines and (b)products or services that are essentially similar in terms of customers/users, technology, workforce oremployee types, and planning.

The applicant has business units in different businesses and has (a) multiple performance systems that supportall of its product and/or service lines and/or (b) products or services that are not essentially similar in terms ofcustomers/users, technology, workforce or employee types, and planning. (This option is intended for largeorganizations with multiple business units that operate independently and have different management systemsthat cannot be fairly assessed in a single application.)

If you checked the second option, please describe briefly the differences among the multiple performance systems of yourorganization in terms of management structure, customers, workforce or employee types, technology, planning, andquality systems.

Note: The applicants Eligibility Contact Point will be contacted if the second option is checked. Such applicants may submitone or more supplemental sections in addition to the application report. The use of supplemental sections must be approved

during the eligibility certification process and is mandatory once approved. Fees for supplemental sections are found on page5 of the Baldrige Award Application Forms.

10. Application Format

If your organization applies for the 2009 Award, in which format would you submit the Application Package?(Check one.)

25 paper copies (due date May 21, 2009) CD (due date May 7, 2009)

11. Confidentiality Considerations

Baldrige Examiners are authorized to use cell phones, cordless phones, and Voice over Internet Protocol (VoIP) todiscuss your application.

Yes No

12. Self-Certification Statement, Signature of the Highest-Ranking Official

I state and attest the following:

(1) I have reviewed the information provided by my organization in this Eligibility Certification Package.

(2) To the best of my knowledge,

no untrue statement of a material fact is contained in this Eligibility Certification Package, and

no omission of a material fact has been made in this package.

(3) Based on the information herein and the current eligibility requirements for the Malcolm BaldrigeNational Quality Award, my organization is eligible to apply.

(4) I understand that at any time during the 2009 Award Process cycle, if the information is found not tosupport eligibility, my organization will no longer receive consideration for the Award and will receiveonly a feedback report.


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13. Site Listing and Descriptors

Please refer to the instructions on page 12 of the Baldrige Award Application Formsto complete this Site Listingand Descriptors form. It is important that the totals for the number of employees, faculty, and/or staff and thenumber of sites on this form match the totals provided in response to 7a and 7c on pages 23 of the 2009

Eligibility Certification Form. For example, if you report a workforce of 600 people in response to question7a, the total number of employees/faculty/staff provided in the Site Listing and Descriptors form should be600 (see example below).

Provide all the information for each site, except where multiple sites produce similar products or services. In caseswhere many sites perform the same function, aggregate the sites under one listing and make a summary statementabout the locations instead of listing an address for each one. Use as many supplemental pages as needed toinclude all sites. Supplemental pages should include the same information requested below.

Use as many additional copies of this form as needed to include all sites.

Address of Site(s) Percentage

Sales Revenues Budgets

Number

Employees Faculty Staff

For each site, describe the relevantproducts, services, and/or technologies.

Coyote Hall 381 Faculty 95% Administrative headquarters, instructional85 Campus Way 200 Staff and educational services

Albuquerque, NM 77351

Cactus Hall 17 Faculty 5% Satellite campus for information technology 85 IT Parkway 2 Staff instruction, including a technology labBernalillo, NM 76052

EXAMPLE

xx

x

Address of Site(s) Percentage

Sales Revenues Budgets

Number

Employees Faculty Staff

For each site, describe the relevantproducts, services, and/or technologies.

(Check one or moreabove, and list belowthe number and typeof workforce membersat each site.)

(Check one above,and list below the% at each site.)


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2009 Eligibility Certification Form P a g e 8 o f 1 0


14. Key Business/Organization Factors

The Baldrige National Quality Program needs the following information to avoid conflicts of interest whenassigning Examiners to evaluate your application. Examiners also use this information in performing theirevaluations. Please be as specific as possible.

List, briefly describe, or identify the following key business/organization factors. Key means those organizationsthat constitute 5 percent or more of your competitors, customers/users, or suppliers.

a. Description of the applicants main products and/or services and of the major markets served(local, regional, national, and international)

b. List of key competitors

c. List of key customers/users

d. List of key suppliers/partners

e. The name of the organizations financial auditor

f. The applicants fiscal year (e.g., October 1September 30)


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One senior member* from each applicant organization that submits its Eligibility Certification Package (witha proof of the mailing date) on or before March 2, 2009, may be nominated to become a member of the2009 Board of Examiners. The opportunity to learn and the required time commitment are substantial.

The time commitment is a minimum of 114 hours from April to December (including approximately 40hours in April/May to complete prework for the Examiner Preparation Course, 34 days in May to attend thepreparation course, and another 5070 hours from June through September to complete the Independent andConsensus Review). If requested by the Program, Examiners also are expected to participate in the Site VisitReview (approximately 9 days). All board appointments are for one year only. Please note that travel andhousing expenses incurred for the Examiner Preparation Course must be covered by the applicant or his/herorganization. Also, if your organization already has representatives on the Board of Examiners, nominating anadditional person may impact the competitive selection of the existing representatives of your organizationfor another term, as the Program limits the number of Examiners it selects from any particular organization.

Nominees must be citizens or permanent residents of the United States, located in the United States or itsterritories, and actual employees of the applicant organization. In addition, they must not have served

previously on the Board of Examiners.

__________________________________ from our organization will serve on the 2009 Board of Examiners.Name of Senior Member Nominee*

I understand that costs associated with participation in the Examiner Preparation Course will be coveredby the Examiner Nominee or by his/her organization.

Nominees contact information:

Mr. Mrs. Ms. Dr.

Title_______________________________________________

Organization_______________________________________________ ____________________________________________

Work Address Home Address_______________________________________________ ____________________________________________

_______________________________________________ ____________________________________________

Note: Place an asterisk next to your preferred telephone number, fax number, and e-mail address.

Work Telephone No. Home Telephone No._______________________________________________ ____________________________________________

Work Fax No. Home Fax No._______________________________________________ ____________________________________________

Work E-Mail Address Home E-Mail Address_______________________________________________ ____________________________________________

15. Nomination to the Board of Examiners

* In a change from previous years, this opportunity is available only to first-time Examiners. If the

nominee has ever served as a Baldrige Examiner for the Baldrige National Quality Program, he/she

is not eligible for this noncompetitive appointment to the Board of Examiners.


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2009 Eligibility Certification Form P a g e 1 0 o f 1 0Malcolm Baldrige National Quality Award


16. Eligibility Certification Filing Fee

Provide payment for the $150 nonrefundable fee to cover the cost of the eligibility filing process. Please indicatewhich method of payment will be provided:

Check (enclosed) Money order (enclosed) ACH payment Wire transfer

Visa MasterCard American Express

Check or money orderPlease make your check or money order payable to theMalcolm Baldrige National Quality Award.

ACH payment or wire transferChecking ABA routing number: 075-000-022Checking account number: 182322730397Please reference the Malcolm Baldrige National Quality Award with your payment.ASQ must be notifiedeither by phone at (414) 298-8789, ext. 7205, or e-mail at [email protected] before an ACH payment or

wire transfer is sent.

Visa, MasterCard, or American Express

Credit Card Number Authorized Signature_______________________________________________ _______________________________________________

Expiration Date Printed Name_______________________________________________ _______________________________________________

Billing Address for Credit Card Todays Date_______________________________________________ _______________________________________________

_______________________________________________

W-9 Request

If you require an IRS W-9 Form (Request for Taxpayer Identification Number and Certification), please contactASQ at (414) 298-8789, ext. 7205.

17. Submission of Eligibility Forms

The 2009 Eligibility Certification Package must be sent on or before April 7, 2009 (on or beforeMarch 2, 2009, if you include a nomination to the Board of Examiners), to be considered for the 2009Award. The Eligibility Certification Package must include a proof of the mailing date. One option tofulfill this requirement is to send the package via a delivery service (e.g., Airborne Express, FederalExpress, United Parcel Service, or the United States Postal Service [USPS] Express Mail) that automaticallyrecords the mailing date. If the package is mailed through the USPS (via a service other than Express Mail),applicants must inc

2009 Award Application Forms

Documents

Transcript of 2009 Award Application Forms