Your contact details

 
 
First Name*
 
 
Last name*
 
 
 
Email address*
 
 
 
Mobile*
 
 
Phone
 
 
 
Region*
 
 
Organisation name
 
 
 
Role*
 
 
If other role, please specify
 
 
 
 
 
 
Postal address line 1
 
 
 
Postal address line 2
 
 
 
Postal address line 3
 
 
 
Town/City
 
 
Post Code
 
 
 
 
 
 
 
 

Preferred event and payment details

 
 
BCS Assessment location - please choose*
 
 
 
 
Email address for payment*
 
 
Purchase order or invoice reference no.
 
 
 
 
 
 
I would like my details to be added to the list of Certified Assessors on the DairyNZ website once I become certified
 
 
 
I confirm I have read and agreed to the Code of Practice*
 
 
 

>> Read the Code of Practice