NSW Farmers Association - Chemical Card Application Form

Chemical Card™

Benefits of Chemical Card™ Less or no time off the farm Home study allows you to complete part of the course at home and then participate in a ½ day (refresher) or one day (initial) workshop at a location near you or Home study and participation in an online workshop allows you to complete the course without leaving home Less $ NSW Farmers’ Association members, employees and family all receive substantial discounts Recognised by Dept of Environment, Climate Change & Water as meeting the requirements of the Pesticides Act Recognised by chemical resellers and APVMA Nationally accredited training, recognised by all training providers at AQF3 Accreditation is valid for 5 years

How do I register?
You must register at least 7 days prior to the workshop date to allow time for dispatch and completion of the home study materials.

Privacy
Information supplied will be retained and managed in accordance with NSW Farmers’ Association Privacy Policy (copy available at www.nswfarmers.org.au or call 1300 794 000).

What do I need to bring?
Your completed home study material, pen & calculator. Morning and afternoon tea will be provided.
Initials – please bring your lunch
Refreshers – please bring evidence of previous chemical accreditation (card or certificate).
We will contact you prior to the workshop with venue details.

Registration Terms and Conditions
Registration must be accompanied by payment. Registrants will be liable for payment in the event of non-attendance. Cancellations will be accepted for up to 5 days prior to the workshop date; following this a substitute participant of equal value will be accepted. Courses will only run if sufficient enrolments are received.

Your Personal Details * compulsory field
NSW Farmers' Member No
Title*
First Name*
Surname*
Business Name
Address*

Town/Suburb*
State*
Postcode*
Main Phone No*
Mobile
Fax
Email
Special Requirements

Course Selection
Course Location*	Course Type*

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Chemical Card™

Benefits of Chemical Card™

Your Personal Details

Course Selection