Collection Agent Nomination Registration Form

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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