DairyNZ Progression Groups
Canterbury/North Otago 2015/2016
 
Contact Details:
 
 
 
First Name*
 
 
Last Name*
 
 
Mobile phone
 
 
Supply Number
 
 
Email Address*
 
 
Address line 1
 
 
Address line 2
 
 
Town/rural area*
 
 
Role (please choose)*
 
 
If you chose 'other' as your role, please specify
 
 
Time in the dairy industry*
 
 
Please choose grp:*
 
 
 
 
 
 
 
Preferred location: Please note that groups will be run in areas where there is demand. *
 
 
  
 
Second choice: Please choose a second location if you are willing to travel
 
 
 
 
 
If more than one person is attending, please enter their details below. 
 
 
 
Full name
 
 
Mobile phone
 
 
Role (please choose)