Q-Alpaca program - Form Q1 - Online Application
If you would prefer, you may submit your application by downloading the Q1 Form, (6 October 2008) completing it and mail or fax it to the AAA Office. The other forms for download are Q2 (Agreement), Q3 (Annual Stock), Q4 (Post Mortem) and Q5 (Herd/Property Plan).

Responses from this on-line form are e-mailed directly to Q-Alpaca Administrator and the AAA Ltd. National Office.

*Mandatory Fields

All Yes/No fields are also mandatory. If you indicate Yes, please complete all subsequent fields relevant to that entry.

	Response
Identity of the person completing this application
Name:
Address
Are you the owner of the Alpacas on the property?*	Yes No (Yes/No)
Are you the manager of the property?*	Yes No (Yes/No)
Number of alpacas on property at date of application
Total number of alpaca on the property LESS than 12 months of age:*
Total number of alpaca on the property 12 months of age and OVER:*
Property where the alpacas are kept
Name of property
Property Identification Code number (PIC no.)
Road Address
State	WA NT SA QLD NSW ACT VIC TAS
Postcode
AAA Region	Queensland Sth Qld/ Nth NSW NSW-Central West NSW-Cntrl Coast Hunter NSW-Sydney C&H NSW-Hawk Blue Mtns NSW-Southern Vic-Central Vic-Eastern Vic-Western Tasmania Sth Australia WA-Central WA-Southern Other
AAA herd code & herd prefix
Contact person on property
Telephone Number
Fax Number
Mobile Phone Number
e-mail address
Veterinarian who will run the Q-Alpaca Program for this property
Name
Address
Telephone Number
Fax Number
Mobile Phone Number
e-mail address (important)
Is the veterinarian APAV approved?*	Yes No (Yes/No)
If the veterinarian is not APAV-approved, does he/she have the approval of the state Chief Veterinary Officer to conduct any post-mortem examinations required by the Program?*	Yes No (Yes/No)
AlpacaMAP
Is the herd currently in the AlpacaMAP?*	Yes No (Yes/No)
If "yes' to above, please complete the next three questions
What is the MN status?
Certificate Number?
Date of expiry of the Certificate?
Other species grazed on the property
Have any dairy or dairy cross cattle been grazing on any part of your property in the past 24 months?*	Yes No (Yes/No)
Do you currently have any beef cattle grazing on any part of your Property?*	Yes No (Yes/No)
Is the herd currently in the CattleMAP?*	Yes No (Yes/No)
If "yes' to CattleMAP, please complete the next three questions
What is the MN status?
Certificate Number?
Date of expiry of the Certificate?
Do you currently have any sheep grazing on any part of your Property?*	Yes No (Yes/No)
Is the herd currently in the SheepMAP?*	Yes No (Yes/No)
If "yes' to SheepMAP, please complete the next three questions
What is the MN status?
Certificate Number?
Date of expiry of the Certificate?
If "no" to SheepMAP, please complete the next question
what is the current ABC score for all these sheep?
Do you currently have any goats grazing on any part of your Property?*	Yes No (Yes/No)
Is the herd currently in the GoatMAP?*	Yes No (Yes/No)
If "yes' to GoatMAP, please complete the next three questions
What is the MN status?
Certificate Number?
Date of expiry of the Certificate?
Do you currently have any deer grazing on any part of your Property?*	Yes No (Yes/No)
Is the herd currently in the DeerMAP?*	Yes No (Yes/No)
If "yes' to DeerMAP, please complete the next three questions
What is the MN status?
Certificate Number?
Date of expiry of the Certificate?
To finalise the application, please complete the next two items
Please enter your name as an electronic equivalent of signing
Date of this application

Any Comments