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, or a cluster of vineyards if owned and managed as one business in the same wine region. Please refer to the Entwine Reporting Guide for specific advice on answering these questions. When completing this form only include resource use associated with the vineyard (do not include winemaking, cellar door or restaurant), if separate metering is not conducted please make a considered estimate.

All fields are mandatory, if a question does not relate to your vineyard please enter 0 in the text field provided.

Entwine Australia Indicators

1.	Financial Year of Data Collection	Select 2007 / 2008 2008 / 2009 2009 / 2010 2010 / 2011 2011 / 2012 2012 / 2013 2013 / 2014 2014 / 2015
2.	Tonnes of Grapes Produced	(T)
3.	Area Under Vine (Excluding Headlands)	(Ha)
4.	Total Purchased Electricity	(kWh)
5.	Total Water Use	(ML)
6.	Total Nitrogen Applied	(Kg)
7.	Total Unleaded Petrol Use	(L)
8.	Total Diesel Use (Excluding Biodiesel)	(L)
9.	Total LPG Use	(L)
10.	Did you maintain a mid-row cover crop this year?	YesNo
11.	If 'YES' for question 10, Did you maintain the cover crop year round?	YesNo
12.	If 'YES' for question 10, What percentage of the total vineyard floor was covered by:
	Volunteer sward	(%)
	Sown or managed (sown in previous years) native species	(%)
	Sown non-native species	(%)
13.	What is the area of land in hectares (Ha) that you actively manage, with the primary goal of maintaining and or reintroducing a natural ecosystem and biodiversity?	(Ha)
14.	What type of irrigation system is predominantly used on your vineyard (Please check one of the following):
		Drip irrigation Under vine sprinklers Overhead sprinklers Flood / Furrow Non-irrigated or other
15.	Please estimate the contribution to vineyard irrigation from the sources below (Must add up to 100% or 0%)
	River water	(%)
	Groundwater	(%)
	Rain water run-off collected on the property	(%)
	Recycled winery wastewater	(%)
	Recycled wastewater from a non-winery source	(%)
	Mains water	(%)
	Other	(%)

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Environmental Management Certification

Full Entwine membership applicants only
What scheme is your company certified to?	Freshcare ISO14001
What is your certification number (if applicable)?
What date does your certification expire?	Select Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Select 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Preliminary Entwine membership applicants only
What certification scheme does your company intend to become   certified to?	Freshcare ISO14001 Generational Farming

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Entwine Australia Fees

Entwine Membership Dates Your submission for Entwine membership provides information on your operational practices for the previous financial year. This information is then returned to you as a benchmark report on your performance relative to other members of the program. To ensure that this information is as accurate and as useful to you as possible, the membership renewal period is July-October for all members. Therefore, if you are joining or your current membership renewal is not due until after October the membership fees are lower as your membership will apply for the remainder of the financial year rather than a full year. New or Renewing Member

New Entwine Australia Member Current Entwine Australia Member (Renewal of membership)

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Vineyard Details

Current Entwine Member Please enter your Entwine No. and email address then press the search button to pre-fill your details.
Entwine No:		Email Address:

Company Name:
Vineyard Name:
State:	Select ACT NSW NT QLD SA TAS VIC WA             Vineyard GI Region:       Select Region
Entwine Accredited   Wine Brands:

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Contact Details

First Name:		Last Name:
Postal Address:
Suburb/Town:		Postcode:
State:	Select ACT NSW NT QLD SA TAS VIC WA	Phone No:
Email Address:		ABN:
Web (Optional):

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  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 (credit card only). 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.