Please note that a Confidentiality/Non-Disclosure Agreement must first be signed, dated and sent to the A3 BEFORE submitting this application. All information provided to the A3 will be held in strict confidence and will not be disclosed in any way.
Click here to download the NDA for this application.
Please upload your signed NDA PDF:
* Please select:
Company Information
* Company Name
* Street Address
Address 2 (if needed)
* City
* State/Province (type N/A if not applicable)
* Zip or Postal Code
* Country
* Website URL
* Telephone Number
* Is your company a member of the A3?
For Non-A3 Member Companies Only - please provide the geographic regions you serve (check all that apply)
Main Contact Person for this Program
* Main Contact Name
Street Address (leave the address portion blank if same as above)
Address 2 (if needed)
City
State/Province
Zip or Postal Code
Country
* Main Contact Telephone Number
* Main Contact Email Address
Certification Criteria
1) Percentage of Sales
* Please provide the percentage of sales directly attributable to system integration (this can include vision, robotics and/or automation integration). Do not include product or component sales, integrated systems sales only.
2) Qualified Personnel
You must have a minimum of one person for every five full time technically competent vision professionals that have passed the A3 Certified Vision Professional - Advanced level examination and have maintained their certification. "Technically competent vision professional" is defined as: An individual having a degree in any engineering science, or an individual who has completed an education in a technical studies program from an accredited institution.
* Number of full time technically competent vision professionals currently employed by your company
* Full names of your employees who are CVP-Advanced certified (separate names with commas)
3) Company Legal Information
* Please provide the date your company was established (MM/DD/YYYY)
* Is your company incorporated?
Please provide your company's full legal name (if different than above)
If you are a startup company, please list the relevant experience of your principals (for the previous five years). Name of principal
List previous vision experience here (for past five years)
Company name principal was employed by
Principal's job title while employed there
Full mailing address of that company
Number of years employed by that company
Contact name at that company (for verification)
Telephone number for contact person
Email address of contact person
Name of second principal (if applicable)
List previous vision experience here (for past five years)
Company name principal 2 was employed by
Principal 2's job title while employed there
Full mailing address of that company
Number of years principal 2 employed by that company
Contact name at that company (for verification)
Telephone number for contact person
Email address of contact person
4) Two Integration Project References
Please list two integration projects that were successfully completed in the last 12 months. Note: the term "project" is defined as any integration design, construction, or implementation service provided by one company in an effort to implement a vision system for another company. These projects must be separate projects, either two different projects for the same customer or two different customers. It does not include modifications to completed projects for an existing or past customer. * Project 1 name
* Project 1 completion date
* Please provide a short summary of project 1
* Customer name (company name)
* Customer street address
* Customer city
* Customer state/province (type N/A if not applicable)
* Customer zip or postal code
* Customer country
* Customer contact person name
* Job title of contact person
* Telephone number of contact person
* Email address of contact person
* Project 2 name
* Project 2 completion date
* Please provide a short summary of project 2
* Customer name (company name)
* Customer street address
* Customer city
* Customer state/province (type N/A if not applicable)
* Customer zip or postal code
* Customer country
* Customer contact person name
* Job title of contact person
* Telephone number of contact person
* Email address of contact person
5) Platforms Used
Please provide a list of all platforms used in designing a vision solution, including what level of software supplier certification has been attained for this platform (if applicable). "Platform" is defined as the fundamental software being used as the foundation for your vision project. This software refers to the standard off-the-shelf package being used to control your vision environment (for example; Sapera, Halcon, Common Vision Blox, MIL, etc.). Platform name (1)
Certification level attained for this platform (if applicable)
Platform name (2)
Certification level attained for this platform (if applicable)
Platform name (3)
Certification level attained for this platform (if applicable)
Platform name (4)
Certification level attained for this platform (if applicable)
Platform name (5)
Certification level attained for this platform (if applicable)
Platform name (6)
Certification level attained for this platform (if applicable)
Platform name (7)
Certification level attained for this platform (if applicable)
Platform name (8)
Certification level attained for this platform (if applicable)
Platform name (9)
Certification level attained for this platform (if applicable)
Platform name (10)
Certification level attained for this platform (if applicable)
6) Industrial Standards/Certifications Achieved
Please list any industrial standards/certification that our company has achieved and maintained (such as ISO 9000). Standard/certification name (1)
Date awarded
Standard/certification name (2)
Date awarded
Standard/certification name (3)
Date awarded
Standard/certification name (4)
Date awarded
Standard/certification name (5)
Date awarded
7) Industry Markets Served References
Please list up to ten primary markets/industries served by your company. You must have successfully completed at least one project within the last five years for each market listed. Note: only verified industry experience will be listed online. Industry name (1)
Project name
Project completion date
Please provide a brief summary of industry 1 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (2)
Project name
Project completion date
Please provide a brief summary of industry 2 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (3)
Project name
Project completion date
Please provide a brief summary of industry 3 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (4)
Project name
Project completion date
Please provide a brief summary of industry 4 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (5)
Project name
Project completion date
Please provide a brief summary of industry 5 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (6)
Project name
Project completion date
Please provide a brief summary of industry 6 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (7)
Project name
Project completion date
Please provide a brief summary of industry 7 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (8)
Project name
Project completion date
Please provide a brief summary of industry 8 project
Customer company name
Customer full mailing list
Customer contact person
Contact person telephone number
Contact person email address
Industry name (9)
Project name
Project completion date
Please provide a brief summary of industry 9 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Industry name (10)
Project name
Project completion date
Please provide a brief summary of industry 10 project
Customer company name
Customer full mailing address
Customer contact person
Contact person telephone number
Contact person email address
Certification Period
The certification period is three years from certification approval date. Companies may apply for certification again after three years, a new application and references are required.Certification Fees
Please note that after the verification process, should your company fail to meet A3's certification criteria, a $500 certification processing/audit fee will be kept and any additional funds paid (this applies to non-A3 member companies) will be returned to you.
A3 Member Companies
A3 System Integrator member companies in good standing pay a $500 USD certification fee. Note: if during the three year certification period, your company drops its A3 membership, you may maintain your certification by paying the pro-rated non-A3 member certification fee.
A3 Member:
Non-A3 Member Companies
System Integrator companies who are not A3 members pay a $3,500 USD certification fee.
Non-Member Integrator:
* I agree that by submitting this form I may receive communications from A3 regarding this and other association activities.
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