Registration Form

PART 1 - Registration Form

First Name(*)

Please enter your first name

Last Name(*)

Please enter your last name

Email(*)

Please enter a valid email address.

Postcode(*)

Invalid Input

Town(*)

Please enter your town name.

Property Name(*)

Please enter your property name.

PIC Number(*)

Invalid Input

I use Tri Solfen and would like to sign up to the Better Choices program.

Yes Invalid Input

PART 2 - You must fill in all the fields to receive your Better Choices certificate and registration number.

Street(*)

Please enter your street name

State(*)

Please enter your state.

Phone(*)

Please enter a valid phone number.

Are you re-registering to Better Choices?

YesNo Invalid Input

If re-registering, please provide your current registration number.

Invalid Input

I require a stencil to be sent to the above address:(*)

Yes No

Please select an answer.

I declare I have used pain relief on mulesed lambs

Yes Invalid Input

Wool Brand(*)

Please enter a wool brand

Number of lamb treated(*)

Please enter the number of lambs treated.

PART 3 - Product Purchased From

Business Name(*)

Please enter your business name.

Business Address(*)

Please enter your business address

Business Town(*)

Please enter your business town

Business Postcode(*)

Please enter your business postcode

reCAPTCHA(*)

Please tick the checkbox.

Submit