Survey

1. Agrecovery Rural Recycling Programme

To help us improve the Agrecovery programme it is important for us to get continual feedback on programme performance.

If you have already completed the survey in the past, please feel free to complete it again. This will help us see if we are improving.

Each quarter we will hold a draw for a $100 dinner voucher at the restaurant of the winner's choice for all completed surveys.

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1. Agrecovery Rural Recycling Programme

*
1. Full name:

2. Membership number (if known):

*
3. Email address:

*
4. Phone number

*
5. Select your farming type (multiple selections possible):

*
6. Please indicate the Agrecovery programmes in which you are interested (multiple selections possible):

Select your farming type (multiple selections possible): Arable Farming Contractor Dairying Forestry Livestock Market Garden / Nursery	Orchard Vineyard Local Authority Manufacturer (agrichemicals, animal health, dairy hygiene) Retailer / Vet Clinic
Other (please specify)

1. Agrecovery Rural Recycling Programme

*1. Full name:

2. Membership number (if known):

*3. Email address:

*4. Phone number

*5. Select your farming type (multiple selections possible):

*6. Please indicate the Agrecovery programmes in which you are interested (multiple selections possible):

*
1. Full name:

*
3. Email address:

*
4. Phone number

*
5. Select your farming type (multiple selections possible):

*
6. Please indicate the Agrecovery programmes in which you are interested (multiple selections possible):