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National Animal Welfare Accreditation

REGISTRATION FORM

NAWA Client Registration Form

ENTITY DETAILS

ENTITY DETAILS

Company

Business Trading Name

Business Type

Company Pty Ltd

Sole Trader

Partnership

Trust

COMPANY ADDRESS

COMPANY ADDRESS

Street Address

Suburb

State

Postcode

Postal Address

Company ABN

Company ACN

Species of Livestock Transported (select all that apply)

Cattle

Sheep

Pigs

Goats

Poultry

Horses

Other

Other

CONTACT DETAILS

CONTACT DETAILS

Business Contact Name

Position

Phone Number

Email Address

Free Text

This is the person whom CoRLink will contact for all correspondence relating to your membership including certification. This person will also receive the primary login for the membership.

Accounts Contact Name

Phone Number

Email Address

Free Text

This is the person whom CoRLink will contact for all correspondence relating to payments and invoicing.

ACCREDITATION DETAILS

ACCREDITATION DETAILS

NHVAS Accreditation

Yes

No

NHVAS Accreditation Number

NHVAS Accreditation Modules

Mass Management

Maintenance Management

Basic Fatigue Management (BFM)

Advanced Fatigue Management (AFM)

TruckSafe Accreditation

Yes

No

TruckSafe Accreditation Number

TruckCare Accreditation (if applicable)

Yes

No

TruckCare Accreditation Number

WAHVA Accreditation

Yes

No

WAHVA Accreditation Number

WAHVA Accreditation Modules

Maintenance Module

Fatigue Module

Dimension & Loading Module

Mass Module (Voluntary)

Are you a member of a State Trucking Association?

Yes

No

If yes what is your membership number

BUSINESS OPERATIONAL DETAILS

BUSINESS OPERATIONAL DETAILS

Number of Prime Movers

Number of Dollies

Number of Trailers

Number of Schedulers

Number of Drivers

SPACER

Please indicate your preferred approach to implementing an Animal Welfare Management System under the CoRLink NAWA Scheme

Develop and implement my/our own tailored Animal Welfare Management System aligned to the NAWA Business Standards.

Implement the CoRLink Tailored Animal Welfare Management System provided as part of the Scheme.

SPACER

Please indicate your preferred mechanism for maintaining records and demonstrating compliance with the NAWA Business Standards

CoRLink NAWA Digital Platform

Hard Copy Mechanism (paper-based system provided by CoRLink)

COMPLIANCE DECLARATION

COMPLIANCE DECLARATION

Has the applicant or an associate of the applicant had any accreditation under the HVNL, previous corresponding law, or another accrediting body, amended, suspended or cancelled?

Yes

No

If yes, provide full details in the section below

Has the applicant, or an associate of the applicant, ever been found guilty of, or received any penalty, sanction, or enforcement action in relation to animal welfare or animal cruelty legislation, regulation, or code of practice?

Yes

No

If yes, provide full details in the section below

Has the applicant, or an associate of the applicant, been subject to any investigation, prosecution, or enforcement notice regarding animal welfare, livestock handling, or animal cruelty matters within the last five (5) years?

Yes

No

If yes, provide full details in the section below

Has the applicant, or an associate of the applicant, had any livestock or animal welfare-related authorisation, licence, permit, or accreditation (including but not limited to saleyard, transport, or animal handling approvals) amended, suspended, or cancelled due to welfare or cruelty violations?

Yes

No

If yes, provide full details in the section below

Is the applicant, or an associate of the applicant, currently under investigation or subject to any pending proceedings for alleged animal welfare or animal cruelty violations?

Yes

No

If yes, provide full details in the section below

DECLARATION OF TERMS AND CONDITIONS

DECLARATION OF TERMS AND CONDITIONS

I acknowledge that I have read, understand and agree to be bound by the terms of the CoRLink Business Rules, Codes of Conduct, and the Accreditation Standards applicable to my membership (as amended from time to time). I further acknowledge and agree to the membership terms and conditions and that payment of membership fees does not in any way guarantee certification under the TruckSafe program. I understand my membership may be cancelled if the information i have submitted on this form or the single vehicle owner-driver declaration (if applicable) is found to be incomplete or false.

I Agree

Declaration of Authority: By completing and lodging this form, the person doing so warrants that they have authority on behalf of the member to complete and lodge this form and make the declarations contained in it.

I Agree

I acknowledge that my email address listed above will be added to the CoRLink Weekly Information Newsletter.

Yes

No

CLIENT SIGN-OFF

CLIENT SIGN-OFF

First Name

Last Name

Date

PRIVACY STATEMENT

PRIVACY STATEMENT

CoRLink is committed to protecting your privacy. We only use your information for the purpose for which you have provided it and for directly related purposes. CoRLink will not disclose your personal information to third parties, unless your consent is given, or in circumstances where such disclosure is required or authorised by law.

Thank you for registering your interest in the NAWA Scheme.

You’ll find a confirmation email in your inbox verifying we’ve received your application. After it’s assessed, we’ll send you clear instructions on how to get started with the digital app.

Oops, there was an error submitting your registration.

Please try again later.

The National Animal Welfare Accreditation Scheme (NAWA) is an initiative developed and operated by CoRLink.

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