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Become a Collection Agent
First Name*
Last Name*
Phone*
Email*
Address*
Country*
Suburb/City*
State
Postcode*
Breed(s) of Interest
Breed*
Experience (Please list any items or specific areas of interest that you feel would be beneficial to your application)*
Why would being an Orivet DNA Collector be something you want to do?*
Why are you interested in applying to become a DNA Collection Agent?*
What other areas of interest do you have outside of the dog/cat world?*
Have you used DNA Testing for your breeding program previously?*
Yes
No
If Yes, please clarify for what purpose and for how long*
Which organisation(s) have you used for genetic testing?*
Do you regularly attend shows, agility trials and other (canine/feline) events?*
Yes
No
If Yes, approximately how many per month?*
Do you have access to a microchip scanner?*
Yes
No
Are you a registered implanter?*
Yes
No
If Yes, what course and your registered number*
Registered number*
Do you visit your member body showgrounds regularly?*
Yes
No
How often?
I agree to have my mobile and email details made public for members to access.
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