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Personal Information

Please enter your first name.

Please enter your last name.

Please enter the name of your organisation if applicable.

Contact Information

Please enter your email address.

Please enter your phone number. Please use landline contact number in this field if available as there is another field for mobile numbers.

Please enter your mobile phone number. If there is not a mobile number applicable please renter the landline phone number.

Please enter your preferred mailing name.

Please enter in your postal address and/or PO Box.

Membership Details

Required if you select family in group type.

Preferences

Please indicate whether or not you approve of Cedar Grove & District Landcare Group Inc. to use your photograph from any events you may attend for one or more media releases from Cedar Grove & District Landcare Group Inc. Please indicate Yes or No.

Please select this option to Yes if you wish to receive a Monthly Newsletter posted to you in the mail.

Select whether or not you would like to receive the monthly Newsletter via email.

Property Information

Please enter the physical address of your property.

Please enter in the RP Number of your property address. Leave blank if you do not have this information available.

Please indicate the land size of the property (please do not forget to indicate what method of measurement you are using eg. acres, hectares)

Please select from the drop down menu what purpose you use your land for.

Other land use such as; partially cleared, orchid, vegetable garden, etc.

Please indicate the local catchment of your property address.

Please indicate whether the property is Land for Wildlife - Yes or No.

Please indicate whether the property is apart of a Volunteer Conservation Management - Yes or No.

Please indicate whether the property is or is not a nature refuge - Yes or No.