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This is a complimentary service and only takes a few minutes to complete.

Date of Application *

Nature of the business (please select): *

Please check ALL certification that currently apply to your product[s]: *

Company Name *

Email *

Street Address *

Street Address Line 2

City *

State/ Province *

Postal/ Zip Code *

Telephone Number *

Your Name or Contact Person*

Title or Position

Brand name(s) of products to be verified (please type the private labels) *

The product to be verified is produced *

Are any of your products currently verified as halal? *

Number of products to be approved for Halal verification? *

Is Pork (or any pig derivative/material) handled, processed or stored on site? *

Is alcohol used as an ingredient in any of the above products? *

Are you willing to display our trademarked Scan Halal logo on verified products? *