Member Application Form Application to Register a Stud Step 1 of 4 - Contact Details 0% Application to Register a Stud NOMINATED STUD PREFIX/NAME(Required) TRADING NAME OWNER NAME/S(Required) ADDRESS(Required) Postal Address Same as residential POSTAL ADDRESSAlternative Address PHONE(Required) MOBILE EMAIL/S(Required) WEBSITE FOUNDING FLOCK INFORMATION SHEEP PURCHASED FROM:Vendor Name/s Date of Purchase Vendor Flock Prefix Vendor Flock No. NUMBER OF SHEEP PURCHASEDRams(Required) Electronic ID or eartag number/s(Required)Ewes(Required) Electronic ID or eartag number/s(Required) FLOCK HEALTH STATUSOvine Brucellosis Flock Accreditation(Required) Yes No Accreditation Number Expiry Date Comment All sheep are Johnes Disease Approved Vaccinates(Required) Yes No If yes, I have continuously vaccinated all retained lambs since (Year) All sheep are from a SheepMAP flock(Required) Yes No If yes, Status: Year commenced in SheepMAP TERMS AND CONDITIONS For your application to be considered, the Vendor must email a Letter of Verification to secretary@polwarth.com.au The letter should state the Purchasers full name, address and mobile number, date of purchase, number and eartags of rams and ewes purchased. As a member of the Polwarth SBAA with a registered flock you are entitled to receive newsletters, the annual flock book, minutes of meetings, to vote at meetings and to exhibit sheep at the major shows around Australia. Members are required to submit an annual return at the end of each financial year and pay the appropriate membership fees. As a member of the association you agree to have your name/s, contact details and details of your flock published on the Polwarth website at www.polwarth.com.au.Signature(Required)Date DD slash MM slash YYYY