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Parlour Safe - Initial Registration form

IAgrE is the administrator for the Parloursafe scheme

Personal information
First name:*


Last name:*


Initials:


Title:


Your preferred name:


Sex:
Male
Female

Date of birth:*


Home address - Street 1:


Home address - Street 2:


Home address - Town:


Home address - County:


Home address - Postcode:


Home address - Country:


Personal email (this is how we communicate with you):*


Repeat personal email:


Telephone no:


Mobile tel no:


College Information (only complete if you are an apprentice/student on a full-time course)
College name:


Course name:


Course completeion date:

Employer's Information
Manufacturer:*
Boumatic
Deleval
Fullwood
GEA Technologies
Lely
Independent Dealer
None of the above

Employer's name:


Employer's address 1:


Employer's address 2:


Employer's address 3:


Employer's address 4:


Employer's postcode:


Employer's tele no:


Employer's email:


Terms and Conditions

The MEA, as owners of the Parlour Safe Scheme, seek your permission to hold your information on the Parlour Safe Registration database and to allow IAgrE as administrators of Parlour Safe registration, and MEA Council representatives from the milking equipment manufacturer under which your registration is made (if applicable), to access your information for management, administration  and registration purposes.

Please tick the box to confirm you have read and accepted the Terms & Conditions