* required fields
1. Type of Product:
2. Company Name:
Address:
Telephone No:
Fax No:
Contact Name:
Email Address:
Hours of Operation:
3. Plant Facility:
4. Standard Required:
Section:
Date Published:
5. Please describe the equipment/products to be Certified:
6.a) For products certified by organizations other than CSA International, please indicate certification organization:
b) Is the full test data available to submit to CSA International for review? Yes No
7. Once this Form has been submitted, a certification specialist will contact you to help you complete the Product Material Information (PMI) form.
If you prefer to send a printed copy of this Form to CSA International, our Mailing Address and Fax Number are:
Customer Service CSA International 178 Rexdale Blvd. Toronto, ON., M9W 1R3
Fax: (216) 328-8138 Telephone: 1-800-463-6727 E-mail: certinfo@csa-international.org
8. I agree to provide CSA with all pertinent documentation required to accurately access the Product for certification. I understand that in order for my products to become CSA certified and bear the CSA Mark, I will be required to sign a CSA Product Service Agreement. I will also inform CSA if any changes occur in the manufacturing of the product during and after the certification process.
Purpose of Collection: The information collected in this online form will be used for the purpose of gathering the necessary information to evaluate your Certification and Testing request.Disclosure: This information will not be released to any third party except as required by law
