.

	Name of the factory (Manufacturing Unit)
	Address Key Contact person for correspondence Name and Designation Phone no Email id Website
	Type of ownership (Public Ltd., private ltd., proprietor/partnership firm etc.)
	CEO / Executive Director/ Proprietor/ Chief Functionary (Name, designation, email id and phone number)
	Year of Establishment
	Key buyers/brands (mention the names)
	Do they have any registration number? Please mention registration number with type of registration number?
	Member of AEPC (pls mention the date since when)? Or any other Apparel/textile network (pls mention the date)?
	Does your company fall under section 135 schedule VII of Companies Act 2013 (CSR)- if yes then mention activities and CSR spend in the last two financial years (FY2016-2017 and FY 2017-2018)
	Is there any Anti Sexual harassment at work place policy (Prevention of Sexual Harassment at Workplace- POSH Act 2013)? When it was drafted?
	Do you have instituted an Internal Committee (IC) in this factory unit	Yes No
	Do you have trainings on POSH Act 2013
	Number of employee and contract staff as on 31 st Dec 2018	Women...... Men...... Transgender...... Total......
	Level-wise data (disaggregated based on gender) as on date

		Women	Men	Transgender	Total
a.	CEO/Factory head
b.	Senior Management
c.	Middle/ Junior Management
d.	Supervisors
e.	Quality checker in-charge
f.	Workers-Permanent
g.	Workers-Contractual
h.	Workers- Casual
Total

	Do you have any systematic programme on Gender equality and prevention of sexual harassment at workplace (POSH) during FY 2017-2018	Less than one-week programme More than a month 3-6 months and above
	Is your factory unit interested to take up a systematic programme on Gender equality and prevention of sexual harassment at workplace (POSH), pls. specify why
	If not interested, pls. mention why/comment
	Any additional Information you would like to share with us

Submit

For more details and any query kindly write to : akumar@changealliance.in

1. HR executives, Industrial Engineer, Floor Incharge, Housekeeping incharge, Packaging and Washing incharge

2. Full time on the rolls of the company

3. Not on the rolls without the benefits of PF/ESI, piece rate work or seasonal job work