Form B

CertiPUR-US^® Program Registration | Form B Terms of Use Agreement

This is an agreement to follow the CertiPUR-US^® Terms of Use, which gives details on how the CertiPUR-US^® name, logo and mark can and cannot be used — and what marketing claims can and cannot be made with the program. Please read the entire CertiPUR-US^® Terms of Use Manual before agreeing to the terms by submitting Form B below. We encourage you to share the Terms of Use Manual with your team members who will be selling, marketing, developing content or talking with customers about your products that contain certified foam.

If you cannot fill out the online form below, email [email protected].

To register, please fill out this form on behalf of the company you represent only if you are purchasing CertiPUR-US^® certified foam or products containing certified foam. A company must be registered to be granted permission to use the CertiPUR-US^® program’s trademarked
name, logo or mark.
There is no cost to register, but in addition to this Form B, your supplier of CertiPUR-US^® certified foam, or products containing certified foam, must submit CertiPUR-US^® Program Supplier Verification Form A available at certipur.us/FormA. — Exception: if you are a retailer selling brands that are already listed in our directory and you do not offer any house or private label brands containing CertiPUR-US^®certified foam, then you do not need Supplier Verification Form A.
Please remember that you do not have permission to use the CertiPUR-US^® name, logo or mark until your company or brand is registered and listed on our website. Once registered, if you do not adhere to the Terms of Use, you will no longer have permission to use the CertiPUR-US^® name, logo or mark and your listing on our website will be removed.
All registered companies must renew their registration and confirm or update their directory listings by submitting Registration Renewal Form C.
Translations: Some key program documents, including our Terms of Use, are available in other languages on our Translations page.

Certificate of Knowledge Requirement

Before you complete Form B, you will need to successfully complete the free online CertiPUR-US® Certificate of Knowledge course at certipur.us/certificatecourse. The course should take 20 minutes. When you complete the course, keep following prompts to download your certificate. Your certificate will include the 16-digit number required below:

Course Certificate Number *

Section 1. Basic Information

This form should only be completed by an authorized representative of the Parent Company/Main Company named below.

Parent/Main Company Name *

Parent/Main Company Address

Address Line 1

Parent/Main Company Address *

Address Line 2

City

State / Province / Region

City *

State / Province / Region *

Postal Code

Country

Parent/Main Company Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Parent/Main Company Phone *

Please include country code if applicable.

Parent/Main Company Email *

Parent/Main Company Phone *

Parent/Main Company Email *

Parent/Main Company Website *

Enter the website for PARENT/MAIN company. You can provide websites or webpages for other companies or brands in Section 3. This is a required field.

Company or Brand Website *

Company Contacts

Please list Primary Contact first. In addition to a Primary Contact, please list a Customer Service Contact, if different. We will call or email the Customer Service Contact if we receive a question from a consumer about one of your products they have purchased (concerns, care instructions, etc.) We also suggest providing a Marketing/PR Contact.

Company Contact

Name *

First

Last

Name *

First

Last

Job Title *

Job Role *

Contact Information

Email *

Phone Number *

Please include country code if applicable.

Extension

Please include an extension if applicable.

Phone Number

Extension

Check “Yes” to add additional contacts

Section 2. About Your Supplier(s) of CertiPUR-US® Certified Foam

Confidential. For use by CertiPUR-US® administrators only.

List the foam supplier (foam producer, reseller, or distributor) from whom you DIRECTLY buy certified foam or products containing certified foam.

If you are buying directly from a participating foam producer, we recommend you check their certificate on our website to be sure the foams you are buying are certified and in good standing. Go to certipur.us/producers and click on the name of your supplier to find their certificate. If you are buying from a distributor or reseller, check to be sure they are registered with us here: certipur.us/directory. Email us at [email protected] if you have questions.

Supplier 1

Company name: *

Primary contact name: *

Email address: *

Supplier 2

Company name:

Primary contact name:

Email address:

Supplier 3

Company name:

Primary contact name:

Email address:

If you have more than 3 suppliers, please email [email protected]

Identify the CertiPUR-US® Certified Foam Families You Purchase or Your Products Contain

(check all that apply)

Identify the CertiPUR-US® Certified Foam Families You Purchase or Your Products Contain

Other foams

Please specify

Other

Do you use only CertiPUR-US® certified foam in all your products, brands and sub-brands that contain flexible polyurethane foam? *

Section 3. Directory Listing(s) – Free and Required

Registered companies must have at least one directory listing. Multiple listings are encouraged. All listings are free. List any company a consumer or customer would search for.

If your company or brand is not listed in the directory, you cannot use the trademarked CertiPUR-US® name or logo or be associated with the program in any way.

For the public directory listing you create below, we will use the information from THIS SECTION ONLY. For EACH company, brand or collection you want listed, complete the entire section below separately. You will see an option to “add another listing” after you complete your first listing. You will also see a customized option if you have more than 4 listings.

NOTE: If you have a parent company and brands, see box.

Only information from Section 3 will be included in the online directory.

If your parent company is a holding company or conglomerate, you can choose NOT to list it in the directory as long as you have at least one other listing included.

There must be a separate entry in Section 3 for each brand or company that you want listed in the directory, including the parent/primary company.

A. Company/Brand Name

Please type exactly as it should appear in directory: *

B. Website/Webpage

Please enter the website or web page link associated with this company or brand: *

C. Company Type

Choose company type if that company or brand sells CertiPUR-US® certified foam or products containing certified foam.

† List of Foam Producers certifying foams

Other

Please specify

Other

D. Product Categories

For the directory, your company will only be listed in the categories you check. Check at least one. Only check a category if that company or brand sells CertiPUR-US® certified foam or products containing certified foam.

Example: If you manufacture both mattresses and furniture but you only use CertiPUR-US® certified foam in your mattresses, then do not check the upholstered furniture category.

Industry

Foam Distributor
Foam Fabricator
Foam Producer
Foam Producer in the process of certifying foam†

† Foam Producers listed here: certipur.us/producers

Medical-Related Products

Medical-Related Products
Wedge/Leg Elevation Support

Pet Products

Pet Beds
Pet Products
Pet Stairs/Ramps

Suggest another product category below:

E. Location

Check where the product is available for purchase.

For the directory, your company will only be listed in the locations you check. Check at least one.

USA, product available throughout USA

USA, product available throughout USA

If you check this, please do not check the other USA options.

Outside the USA, product available in these countries:

Outside the USA, product available in these countries:

F. Related Listings/Cross-References (Optional)

In this particular listing, do you want us to cross-reference any other listed or related companies or brands you have submitted?

Multiple Choice

Do not cross-reference any other companies or brands in this listing
Cross-reference all related brands among the listings submitted
Only cross-reference these related brands, please specify:

Single Line Text

G. Retailers Only: Brands Sold (Optional)

If you are a retailer, we can add a section to your listing that indicates the brands you sell that contain CertiPUR-US® certified foam and appear in the current CertiPUR-US® online directory.

List brands you sell here: (separated by semicolons)

Comments/Notes (Optional)

Please provide any additional information here that you would like us to know about this listing:

Comments/Notes (Optional)

Do you have another company or brand to list?

I have more than 4 listings of companies/brands and will email [email protected] for a customized approach.

I have more than 4 listings or prefer to submit a separate spreadsheet of companies/brands and will contact [email protected] for a customized approach.

Section 4. Agreement to Abide by the Rules Set Forth in the CertiPUR-US® Program Terms of Use Manual

Obligation to inform others of terms. *

I have read and agree to the CertiPUR-US® Program Terms of Use Manual and understand it is our responsibility to inform employees, contractors and/or consultants that they must follow the Terms of Use.† Translations: Some key program documents, including our Terms of Use, are available in other languages on our Translations page.††

† Find the Terms of Use Manual at certipur.us/TermsofUse.
†† Translations: Some key program documents, including our Terms of Use, are available in other languages at certipur.us/translations.

Permission prior to use. *

I understand that any advertising, packaging, website content, labeling, news release or other promotional materials that carry the CertiPUR-US® name, logo or mark or claims must be submitted to and approved by CertiPUR-US® administrators prior to use.†

† Email [email protected].

Use of name and logo. *

I understand that the CertiPUR-US® name, logo and mark can only be used in association with products in which all the flexible polyurethane foam in the product is CertiPUR-US® certified.

Only the foam is certified. *

I understand that CertiPUR-US® certifies only flexible polyurethane foam, not the finished product, and I must not characterize a whole product or my company as being CertiPUR-US® certified.

Changing or adding a certified foam supplier. *

I understand that if we change or add foam supplier(s), that supplier must submit an updated Verification Form A(s).

Avoiding inaccurate claims. *

I understand that the following claims CANNOT be made in association with CertiPUR-US® certified foams:

Chemical-free
Eco-friendly*
Green*
Hypoallergenic
Made without chemicals
Made without flame retardants
No carcinogens
No flame retardants/free of FRs
Non-toxic
Recycled*
Renewable*
Safe
Sustainable*
Biobased (Exception: Biobased foams)

*Avoid using these or other similar unqualified environmental benefit claims which may be prohibited by the Federal Trade Commission Green Guides, a publication designed to help marketers avoid making environmental claims that may mislead consumers.

Indemnify and hold harmless AFPF, Inc. *

We agree to indemnify, hold harmless and defend AFPF, Inc., (the organization that administers the CertiPUR-US® program), its officers, directors and employees against any damages, liability, costs or expenses, including attorneys’ fees and costs, arising out of third-party claims in connection with our use of the CertiPUR-US® name, logo or mark.

Update Directory Listing Annually *

I understand that I must update my directory listing(s) annually via Form C in order to continue to have permission to use the CertiPUR-US® name, logo or mark. (CertiPUR-US® administrators will send a reminder to update your listing(s) to the primary contact and/or main company contact.)

This form is a legally binding document. *

I have entered my electronic signature below — or signed and submitted a copy of this document — and I understand that in either case my signature is legally binding.

Signature *

Clear Signature

Please use your cursor to sign if you are on a desktop computer.

Print Name: *

Email (for copy of form)

Enter an email address to receive a copy of your form submission.

Email form copy

By submitting this document, I give permission to CertiPUR-US® program administrators to email periodic program updates.

Form B

Form B

CertiPUR-US® Program Registration | Form B Terms of Use Agreement

Certificate of Knowledge Requirement

Section 1. Basic Information

Parent/Main Company Address

Company Contacts

Company Contact

Contact Information

Company Contact

Contact Information

Company Contact

Contact Information

Company Contact

Contact Information

Section 2. About Your Supplier(s) of CertiPUR-US® Certified Foam

List the foam supplier (foam producer, reseller, or distributor) from whom you DIRECTLY buy certified foam or products containing certified foam.

If you have more than 3 suppliers, please email [email protected]

Identify the CertiPUR-US® Certified Foam Families You Purchase or Your Products Contain

If NO, please be sure your corporate, sales, marketing and customer service teams do not state, imply or promote that a product contains certified foam if it does not.

Section 3. Directory Listing(s) – Free and Required

A. Company/Brand Name

B. Website/Webpage

C. Company Type

D. Product Categories

E. Location

F. Related Listings/Cross-References (Optional)

G. Retailers Only: Brands Sold (Optional)

Comments/Notes (Optional)

A. Company/Brand Name

B. Website/Webpage

C. Company Type

D. Product Categories

E. Location

F. Related Listings/Cross-References (Optional)

G. Retailers Only: Brands Sold (Optional)

Comments/Notes (Optional)

A. Company/Brand Name

B. Website/Webpage

C. Company Type

D. Product Categories

E. Location

F. Related Listings/Cross-References (Optional)

G. Retailers Only: Brands Sold (Optional)

Comments/Notes (Optional)

A. Company/Brand Name

B. Website/Webpage

C. Company Type

C. Product Categories

E. Location

F. Related Listings/Cross-References (Optional)

G. Retailers Only: Brands Sold (Optional)

Comments/Notes (Optional)

I have more than 4 listings of companies/brands and will email [email protected] for a customized approach.

Please email [email protected] to submit a separate spreadsheet for your directory listings. You may continue to Section 4 to complete this form.

Section 4. Agreement to Abide by the Rules Set Forth in the CertiPUR-US® Program Terms of Use Manual

CertiPUR-US^® Program Registration | Form B Terms of Use Agreement