EntWine Australia Vineyard Membership Form

Please note: This form should be filled out by vineyard operators only and should take into account one vineyard site only (sites can be multiple vineyards if managed as one business in close proximity).

EntWine Australia Indicators

1. Tonnes of Grapes Produced	(T)
2. Area Under Vine (Excluding Headlands)	(Ha)
3. Total Electricity Use	(kWh)
4. Total Water Use	(ML)
5. Total Nitrogen Applied	(Kg)
6. Total Unleaded Petrol Use	(L)
7. Total Diesel Use (Excluding Biodiesel)	(L)
8. Total LPG Use	(L)
9. Financial Year of Data Collection

Approved EntWine Australia Certification

10. What scheme is your company certified to?
11. What is your certification number (if applicable)?
12. What date does your certification expire?

EntWine Australia Fees

Vineyard operators (growers only):

$110.00 (GST inc.)

Vineyard Details

Company Name:
Vineyard Name:
State:		Vineyard GI Region:

Contact Details

First Name:		Last Name:
Postal Address:
Suburb/Town:		Postcode:
State:		Phone No:
Email Address:		ABN:

Declaration

I declare that the above information is true and accurate to the best of my knowledge.

"After submitting this completed form you will be redirected to our online payment facility to pay the EntWine Australia membership fee to WFA. Your membership will be processed in due course and you will be entered onto the EntWine Australia online register. PLEASE NOTE: Operators using alternate approved certification schemes (other than Freshcare) will also need to provide proof of certification in the form of a certificate to the WFA."