Contact name
Telephone number
Email address
Trading name
Address of premises to be registered
Annual turnover (not used in fee calculation)
Number of staff involved in organic operations

Organic Operation Activity

(Please see the Organic Activity Classification sheet if you are unsure)

Please tick any of the below that apply;
Producer	Grower (Arable and Horticultural Crops, Grass, Mushrooms)	☐
Poultry	☐
Pigs	☐
Beef and Dairy	☐
Sheep and Goats	☐
Aquaculture	☐
Deer	☐
Bees	☐
Land Only	☐
Additional Sites	☐ Yes ☐ No Please detail which scope/s these require below and detail address in email:

Please answer the following questions:

Have you been certified by another organic certification body?	☐ Yes ☐ No
Have you ever been refused certification?	☐ Yes ☐ No
Have there been any prosecutions within the last 12 months or pending which could affect organic certification?	☐ Yes ☐ No
If you have answered “yes” to any of the above please explain why on a separate sheet or detail in your returning email
How did you hear about the Federation?

Site area in hectarage/acreage	Owned: Rented:
Area used by livestock/crops in hectarage/acreage
Livestock Numbers (Please specify if numerous activities)
Aquaculture cages size and numbers
Do any of your sites or your contracted sites hold certification themselves currently	☐ Yes ☐ No
Range of items sold e.g. silage, meat, wool, eggs

On behalf of (company)
Position
Date
Print name
Signed

Please return this form to the address or email below.

Your quotation will be based on this document. Any additional sites, scopes, not mentioned may be charged accordingly.