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User Registration Details

First Name*

Last Name*

Preferred Site Username*

Position in the Business

Email*

Password*

Confirm Password*

Phone Number*

Mobile Number*

Preferred Method of Contact ?

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Business Information

Farm Name

Legal Entity Name

Website Address

Facebook Page

Address Information

Physical Address

Street Address1

Street Address2

RD

City or Suburb

Region

AucklandBay Of PlentyCanterburyHawke's BayManawatu / WanganuiMarlboroughNelson / TasmanNorthlandOtagoSouthlandTaranakiWaikatoWellingtonWest Coast

Postal Code

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Milk Supply Number

Postal Address

Please tick if your postal address is the same.

Information About My Farm

Farm Size (h.a.)

Farm Herd Size

Milking Shed Type

Number of Workers on Farm

Roster (s)

Terrain

What Workers Can Expect

Accommodation Type and Details

Other farm or worker information you’d like us to know?

Internet Available

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Mobile Coverage

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