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Name *

Email *

Date of Birth *

Phone *

Which kind of work do you want?

How long do you want work for? *

Visa Status *

Do you have your own transport? *

Do you have accommodation in the Lockyer Valley? *

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Have you worked on a vegetable or herb farm before? *

What farm work have you done in the past?

List any qualifications, tickets or licences that you have:

Any special requests or information you would like to provide?