2018 Applicant Intent to Apply Form Application Level 1, 2, and 3 2018 Award Process

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2018 Applicant Intent to Apply Form

Application Level 1, 2, and 3

2018 Award Process

  • This is a fill-in enabled form. It can be completed electronically.

  • This form is to be submitted by all Level 1, 2, and 3 Applicants.

  • Mail the completed Intent Form and the $150 Intent Fee to the MAAPE Office; it must be postmarked by January 5, 2018.

  • Additional instructions are provided in Section II of this form.

  • If you have any questions, please call us: 717-737-6470.

MAAPE Mailing Address:

Mid-Atlantic Alliance for Performance Excellence

Award Process

590 Centerville Road #260

Lancaster, PA 17601

Eligibility Requirements

Subunits: A subunit is a unit or division of a larger (parent) organization. Subunits of organizations might be eligible. To be ­eligible, the subunit must be self-sufficient enough to be ­examined in all seven Criteria Categories, and it must be a discrete entity that is readily distinguishable from other parts of the parent organization. It cannot be primarily a support function (e.g., housekeeping, member services, finance and accounting, billing, human resources, purchasing, legal services, or research).

Location: Although an applicant may have facilities outside the state where it is headquartered or may receive support from its parent, in the event of a site visit, the applicant must ensure that the appropriate people and information are available for examination in the applicant’s state. This information is needed to document the operational practices associated with all of its major functions

Multiple-Application Restrictions: A subunit and its parent may not both apply for Awards in the same year. In some cases, more than one subunit of a parent may apply.

Future Eligibility Restrictions: Recipients are eligible to reapply to the MAAPE process annually, except if they receive the MAAPE Excellence Award. Recipients of the Excellence Award are eligible to reapply in the fourth Award cycle after receiving the Excellence Award. For example, an organization that received the Excellence Award in the 2017 Award cycle would not be eligible to apply again until the 2021 Award cycle.

Section I: Applicant Information

1. Applicant

Organization Name as it will appear on Award


Initial the above box if you choose not to receive recognition at the Annual MAAPE Awards Banquet



City State Zip

2. Size and Locations
Total number of employees (full-time equivalent) in the unit applying:      
Number of those employees (full-time equivalent) in PA       NJ       DE      
Percent of assets in PA       NJ       DE      
Total number of sites in the unit applying:      

3. Industry Sector
Please check the sector that best describes your organization:



Health Care


Not for Profit


Small Business

4. Industrial Classification
List up to three of the most descriptive NAICS codes (see Section III of this form for a complete list of codes):
5. Official Contact



Mailing Address


Street Address (no PO Box)


City State Zip


Telephone Fax



6. Alternate Official Contact


Telephone Fax


7. Returning Applicant?
Yes      No     
Application Year(s):

8. Highest Ranking Official




City State Zip

Telephone Fax



9. Application Level
Check one: Description of Application

Level 1 Organizational Profile and 15 page Category-Level Application

Level 2 Organizational Profile and 50 page Item-Level Application

Level 3 Organizational Profile, 50 page Item-Level Application, and Site Visit
Level 3 Site Visit Weeks

Level 3 applicants must indicate 1st and 2nd choice for Site Visit Weeks

Indicate 1st & 2nd Choices:

July 9, 2018

July 16, 2018
Level 3 Education applicants should contact MAAPE if an alternate Site Visit Week is required to work within the school calendar.

Please visit the MAAPE website for:

  • Fees associated with each Application level

  • The level of recognition available to Applicants at each Application Level

Organizations are judged within their respective sectors of Education, Government, Health Care, Manufacturing, Not for Profit, and Service. Any number of organizations may receive Recognition or Excellence Awards in each year.

10. Nomination of Examiners (required for all Applicants)
Application Level Examiner Requirement - Check one and enter the name(s)

Level 1 1 Examiner Name:      

Level 2 1 Examiner Name:      
Level 3 2 Examiners Names:      

NOTE: ALL Examiners will be required to complete pre-work and a 3-day, in-class training course. A series of four webinars will be conducted in January and February to assist examiners in completing their pre-work and preparing for the in-class training. Three in-class sessions will be offered in late February through March at locations in Eastern and Western PA and in NJ. See the MAAPE website for additional information.

11. One-Sentence Organization Description

Please provide a brief description of your organization to be used for publicity and recognition.


12. Applicant's Statement and Authorizing Signature

We certify that our organization meets the eligibility requirements of the Mid-Atlantic Alliance for Performance Excellence Award and the sector in which we intend to apply.

We understand that members of the Board of Examiners will review this application. We agree to participate in the evaluation process, to facilitate an open and unbiased examination, and to reimburse expenses incurred by the site visit team (Level 3 applicants only).
We understand MAAPE’s expectations of us as an Applicant to share our successful improvement strategies and lessons from our performance excellence journey with other Pennsylvania, New Jersey and Delaware organizations, to participate in the annual MAAPE Conference, and to use appropriate methods to communicate and advertise recognition received through the MAAPE Award Process.
Signature of Highest Ranking Official: _____________________________________________
Date: _____________________________________________

13. Intent Fee and Mailing Address

Enclose $150 Intent Fee (non-refundable) made payable to MAAPE to cover initial processing.

Mailing Address:

Mid-Atlantic Alliance for Performance Excellence

Award Process

590 Centerville Rd., # 260

Lancaster, PA 17601

Additional instructions for the Intent to Apply Form are provided in Section II of this form.
Section II: Instructions for Completing the Intent to Apply Form

Please type or print

1. Applicant

Use these fields to provide the official name of the organization as it will appear on the Award and on publicity materials.

2. Size and Locations

Provide the number of full-time equivalent employees (FTE) working at the organization and the number working in Pennsylvania, New Jersey and Delaware.

Full-time equivalent employees are defined as those who regularly work 40 or more hours a week and are entitled to benefits such as paid vacation, sick leave and insurance coverage. Each instance of job sharing, where multiple individuals fulfill the responsibilities of a single position that requires 40 or more hours per week, is counted as a full-time equivalent employee.
MAAPE defines small, medium, and large organizations as follows:

Small: Less than 100 total employees in the unit applying

Medium: 100 to 500 total employees in the unit applying

Large: More than 500 total employees in the unit applying
Indicate the percent of the organization's total assets located in Pennsylvania, New Jersey and Delaware.
Indicate the number of sites to be included in the evaluation.
3. Industry Sector

Please select the sector that best describes your organization. This information will determine the Criteria MAAPE will use to evaluate your application.

4. Industrial Classification

Insert North American Industry Classification System (NAICS) codes most relevant to the organization’s products and/or services (see Section III of this form for a complete list of codes).

5. Official Contact

In these fields, provide complete contact information (using a street address for courier deliveries) for the person at the organization who can provide additional information and arrange a site visit.

6. Alternate Official Contact

In the event the official contact is not available, please provide contact information for an alternate contact with the authority to provide additional information or arrange a site visit. If the official or alternate contact changes during the course of the application process, please inform MAAPE.

7. Return Applicant

Indicate if the organization is a return applicant and if so, year(s) of previous application(s).

8. Highest Ranking Official

In these fields, provide information about the organization’s highest-ranking official (e.g., owner, CEO, president, chairperson, plant manager).

9. Identify Application Level

Please choose the level of recognition for which your organization is applying. See level descriptions on the MAAPE web site.

10. Examiner Requirement

All applicants are required to provide Examiners for the Award Process, both to enhance your organization's understanding of the Baldrige Excellence Framework, and to ensure adequate resources for Application evaluation. Please review Examiner responsibilities on the MAAPE website to help you to select the appropriate individual(s). List the name(s) of the individual(s) in this section and ask the individual(s) to submit an Examiner Application, also available on the MAAPE website.

Please note that if you do not provide the required number of Examiner nominees, or an Examiner nominee does not complete Examiner Training, your organization’s Award Application will not be accepted. If an Examiner nominee completes Examiner Training, but does not participate in the Award Process as an Examiner, MAAPE will assess your organization an additional $500 fee.
11. One-Sentence Description

Provide a brief description of your organization. This description will be used in conjunction with the MAAPE Awards Banquet and for publicity purposes.

12. Signature of Highest Ranking Official

This form should be signed by the Highest Ranking Official listed in Section 8.

13. Intent Fee and Mailing Address

A $150 non-refundable Intent Fee is required to cover the costs associated with the initial processing. The Intent Fee may be paid by check. Submit your payment with the Intent Form.

Submitting your Intent to Apply Packet

Your Intent to Apply Packet should include:

  • Two copies of the Intent to Apply Form

  • $150 Intent Fee

Mail these items to the Mid-Atlantic Alliance for Performance Excellence, postmarked by January 5, 2018:

Mid-Atlantic Alliance for Performance Excellence

Award Process

590 Centerville Road #260

Lancaster, PA 17601

Section III: North American Industry Classification

System (NAICS) Codes

Please insert the NAICS codes most relevant to your organization’s products and/or services on Section I of your Application form.


111 Crop Production

112 Animal Production

113 Forestry and Logging

115 Support Activities for Agriculture and


211 Oil and Gas Extraction

212 Mining (except Oil and Gas)

213 Support Activities for Mining

221 Utilities

236 Construction of Buildings

237 Heavy and Civil Engineering Construction

238 Specialty Trade Contractors

311 Food Manufacturing

312 Beverage and Tobacco Product


313 Textile Mills

315 Apparel Manufacturing

316 Leather and Allied Product Manufacturing

321 Wood Product Manufacturing

322 Paper Manufacturing

323 Printing and Related Support Activities

324 Petroleum and Coal Products Manufacturing

325 Chemical Manufacturing

326 Plastics and Rubber Products Manufacturing

327 Nonmetallic Mineral Product Manufacturing

331 Primary Metal Manufacturing

332 Fabricated Metal Product Manufacturing

333 Machinery Manufacturing

334 Computer and Electronic Product


335 Electrical Equipment, Appliance and

Component Manufacturing

336 Transportation Equipment Manufacturing

337 Furniture and Related Product


339 Miscellaneous Manufacturing

423 Merchant Wholesalers, Durable Goods

424 Merchant Wholesalers, Nondurable Goods

425 Wholesale Electronic Markets and Agents

and Brokers

441 Motor Vehicle and Parts Dealers

442 Furniture and Home Furnishings Stores

443 Electronics and Appliance Stores

444 Building Material and Garden Equipment

and Supplies Dealers

445 Food and Beverage Stores

446 Health and Personal Care Stores

447 Gasoline Stations

448 Clothing and Clothing Accessories Stores

451 Sporting Goods, Hobby, Book and Music


452 General Merchandise Stores

453 Miscellaneous Store Retailers

454 Nonstore Retailers

481 Air Transportation


482 Rail Transportation

483 Water Transportation

484 Truck Transportation

485 Transit and Ground Passenger


486 Pipeline Transportation

487 Scenic and Sightseeing Transportation

488 Support Activities for Transportation

491 Postal Service

492 Couriers and Messengers

493 Warehousing and Storage

511 Publishing Industries (except Internet)

512 Motion Picture and Sound Recording


515 Broadcasting (except Internet)

516 Internet Publishing and Broadcasting

517 Telecommunications

521 Monetary Authorities — Central Bank

522 Credit Intermediation and Related Activities

523 Securities, Commodity Contracts and Other

Financial Investments and Related Activities

524 Insurance Carriers and Related Activities

525 Funds, Trusts and Other Financial Vehicles

531 Real Estate

532 Rental and Leasing Services

533 Lessors of Nonfinancial Intangible Assets

(except Copyrighted Works)

541 Professional, Scientific and Technical


551 Management of Companies and Enterprises

561 Administrative and Support Services

562 Waste Management and Remediation


611 Educational Services

6111 Elementary and Secondary


6112 Junior Colleges

6113 Colleges, Universities and

Professional Schools

6114 Business Schools and Computer

and Management Training

6115 Technical and Trade Schools

6116 Other Schools and Instruction 6117 Educational Support Services

Continued on next page>


621 Ambulatory Health Care Services

6211 Offices of Physicians

6212 Offices of Dentists

6213 Offices of Other Health


6214 Outpatient Care Centers

6215 Medical and Diagnostic


6216 Home Health Care Services

6219 Other Ambulatory Health Care


622 Hospitals

623 Nursing and Residential Care Facilities

624 Social Assistance

711 Performing Arts, Spectator Sports, and

Related Industries

712 Museums, Historical Sites and Similar


713 Amusement, Gambling and Recreation


721 Accommodation

722 Food Services and Drinking Places

811 Repair and Maintenance

812 Personal and Laundry Services

813 Religious, Grantmaking, Civic, Professional

and Similar Organizations

814 Private Households

921 Executive, Legislative and Other General

Government Support

922 Justice, Public Order, Safety Activities

923 Administration of Human Resource


924 Administration of Environmental Quality


925 Administration of Housing Programs, Urban

Planning and Community Development

926 Administration of Economic Programs

927 Space Research and Technology

928 National Security and International Affairs

999 Unclassified Establishments

Mid-Atlantic Alliance for Performance Excellence 2018 Intent to Apply Form for Levels 1, 2, and 3

717-737-6470• midatlanticape.org page

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