Please Refer to the Small Farm Planningguidelineswhile Completing This Form(Available at )

Small Farm Planning 2016Expression of Interest Form

Please refer to the Small Farm PlanningGuidelineswhile completing this form(available at ).

To fill in the form, click in the grey fields and begin typing – the rows will expand as you type. Please use dot points if you wish, however the form does not support bullet formatting so you will need to use [-].

1. Applicant and property details
Applicant name
Property name
Property address / Postcode
Postal address (if different)
Phone/mobile
Fax
Email
PID (property ID).(From your council rates notice)
Property size (ha)
(1ha = 2.47 acres)
Property descriptors (rank 1 - 9 in order of land coverage with 1 being most coverage and 9 being least) / Horticulture: / Cropping: / Improved pasture:
Native bush: / Native pasture: / Environmental weeds:
Conservation area: / Forestry: / Other (please specify):
2. Areas of interest

What are your main goals or objectives forthe coming 3-5 years for your property / Maximum 150 words
What are the maintopics or issuesyou would like to learn about? (Please rank 1-5 in order of preference with 1 being highest preference and 5 being least preference)
Soil health (fertility, structure etc) / Native vegetation / Revegetation & Agroforestry
Pasture management / grazing / Managing native browsing mammals (wallabies, possums etc) / Managing threatened species and communities
Animal husbandry and welfare / Weed management / Water resources
Biosecurity(pest and disease management) / Property layout / Other (please specify):

3. Personal information
How do you describe yourself
Life-styler: You enjoy the natural environment of a bush block
Hobby Farmer: You manage the land as a pastime possibly for small financial gain
Small Scale Farmer: You run a commercial enterprise on a smallholding
Are you available to attend workshops on weekends?
Yes No
Are you prepared to make your property available for a PMP workshop?
Yes No
If yes, can you provide a sheltered area for approx. 25 people?
Yes No
Any further comments (if required)

Conditions

In submitting this Expression of Interest I/we agree that should the application be successful I/we agree that we will pay the program fee of $200 for a single individual or $275 for two individuals per property

I agree that I have read and understood the above conditions

Applicant’s Name or Signature

Date:

Your completed form can be emailed to or faxed to 03 6221 6166or submitted by post to:

Tim Ackroyd

NRM South

PO Box 425

South Hobart TAS 7004

Applications must be received by 5pm, December8th2015.

For further information on the application form or the program please contact:

Tim Ackroyd, NRM South Huon Valley Facilitator, (03) 6264 0324, 0400 047 665