"*" indicates required fields Step 1 of 3 33% Sustainable Winegrowing Australia (AWISSP) Certification Training (Great Southern) - Wednesday, 4 June 2025Please ensure you enter the correct details for your business and that these correspond to the details registered for your Sustainable Winegrowing Australia membership. The details you enter in this form will be printed on your training certificate and registered with Freshcare. Please note, refunds are not provided. If you can no longer attend this event, please contact events@awri.com.au.Business trading name*Business legal name*ABN*Are you a Sustainable Winegrowing Australia Member?*Please select the applicable optionYesNoTrainee name*The trainee should be the site owner/manager or suitably qualified person responsible for management decisions. First Last Phone/Mobile*Email* Dietary Requriements* None Lactose intolerant Gluten intolerant Vegetarian Vegan Kosher Other Street address of vineyard, winery or wine business* Street Address Address Line 2 Suburb State ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Mailing address is the same as above?* Yes No Mailing address* Street Address Address Line 2 Suburb State ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Demographic informationThis information will assist us in tailoring the session for the group.What best describes your role?* Vineyard owner or manager Viticulturist, grower or vineyard worker Winemaker or cellar hand Consultant Certification body Auditor Other How long have you been in that position?* Less than 5 years 5 - 9 years 10 - 19 years 20 - 29 years 30+ years What age group do you belong to?* Less than 29 30 - 39 40 - 49 50 - 59 60 - 69 70+ What size is your vineyard (in hectares)?OptionalWhat size is your winery (in tonnes)?OptionalWhat's your first language?Optional Member registrationThe information you supply in this form will be used to register your business with Freshcare Ltd for the purposes of certification against the Australian Wine Industry Standards of Sustainable Practice. FRESHCARE PRIVACY STATEMENT: The information being collected may be personal information. Freshcare Ltd takes its obligations under the Privacy Act 1988 (Cth) very seriously. The Freshcare Rules explain how and why information is collected, disclosed and published by Freshcare Ltd, in particular at clause 14. By providing the information contained in this form to Freshcare Ltd, you consent to Freshcare Ltd dealing with that information in the manner set out in the Freshcare Rules and the Freshcare Privacy Policy, both available online at www.freshcare.com.auSustainable Winegrowing Australia Membership number(s)*To qualify for registration as a member of Sustainable Winegrowing Australia, you must have completed the data, workbook and payment for the current year. Membership will be verified upon registration. Add RemoveTraining required*You are a wine business if you produce wine but do not have a physical vineyard or winery. Please select 'Wine Business'. Viticulture Winery (includes Wine Business) Viticulture + Winery (includes Wine Business) RegistrationThe information you supply in this form will be used to register your business with Freshcare Ltd for the purposes of certification against the Australian Wine Industry Standards of Sustainable Practice. FRESHCARE PRIVACY STATEMENT: The information being collected may be personal information. Freshcare Ltd takes its obligations under the Privacy Act 1988 (Cth) very seriously. The Freshcare Rules explain how and why information is collected, disclosed and published by Freshcare Ltd, in particular at clause 14. By providing the information contained in this form to Freshcare Ltd, you consent to Freshcare Ltd dealing with that information in the manner set out in the Freshcare Rules and the Freshcare Privacy Policy, both available online at www.freshcare.com.auTraining required*You are a wine business if you produce wine but do not have a physical vineyard or winery. Please select 'Wine Business'. Viticulture Winery (includes Wine Business) Viticulture + Winery (includes Wine Business) Additional attendeeFor in-person training, you may bring an additional attendee, please note that they will not receive a training certificate or have their training registered with Freshcare; therefore, cannot be the representative of the business at audit.Would you like to bring an additional attendee? Yes No Additional attendee name* First Last Dietary Requriements* None Lactose intolerant Gluten intolerant Vegetarian Vegan Kosher Other PaymentTotal All prices are GST (10%) inclusive.Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Δ
