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Pests - Baiting Program Expression of Interest form

Introduction

Information about 1080 and the regulations around its use can be found on our ' Pest animals and approved baiting program' webpage.

Current baiting programs can also be found on our website.

Privacy

Privacy Collection Notice

This personal information in this form is collected by Toowoomba Regional Council for the purpose of assessing the request in this form and performing related functions. Council's privacy policy is available at tr.qld.gov.au/privacy.

Applicant type

Is this application for an individual or a company/organisation? *

IndividualCompany/organisation

Applicant details

Title *

First name *

Last name *

Phone number *

Email address

Company/organisation details

Company/organisation name *

Contact full name *

Phone number

Email address *

Australian Business Number (ABN) or Australian Company Number (ACN) *

Postal address

Postal address *

Suburb *

State *

Postcode *

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Pests - Baiting Program Expression of Interest form

Property details

Baiting address

Provide the address of the property where you'd like to lay baits.

You can list more than one property on this form.

Which baiting location details would you like to provide? *

Street addressLot/planBoth

Street address

How many street addresses apply?

12 or more

Address 1

Property address *

Suburb

State

Postcode

Property size

What is the property size? *

Is the property size in acres or hectares? *

AcresHectares

Address 2

Property address *

Suburb

State

Postcode

Property size

What is the property size? *

Is the property size in acres or hectares? *

AcresHectares

Real property (lot/plan)

How many lot/plan combinations apply?

12 or more

Real property 1

Lot number *

Plan number *

Property size

What is the property size? *

Is the property size in acres or hectares? *

AcresHectares

Real property 2

Lot number *

Plan number *

Property size

What is the property size? *

Is the property size in acres or hectares? *

AcresHectares

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Pests - Baiting Program Expression of Interest form

Preferred baiting station

Select your preferred baiting station *

Baiting background

Have you baited previously? *

YesNo

Past baiting details

Year of last bait

When did you last bait *

Baiting station

Where was the baiting station (the place where Council officers mixed the baits) you used last time?

Baiting group

Were you / are you part of a group that regularly baits? *

YesNo

Who is the contact person for your baiting group? *

Are there other landholders in your area who you coordinate your baiting with? Provide any names below. *

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Pests - Baiting Program Expression of Interest form

Fees

There is no fee for this application.

Declaration

I understand and acknowledge that:

The information provided in this application is true and complete to the best of my knowledge.
Council may refuse this application if it becomes evident that any information or supporting documents provided is incomplete or false.
Council may reserve the right to decline a landholder from participating in the baiting program if it is suspected the landholder may fail in the conditions of use outlined on our website.
I approve of the information that has been provided in this application.
I acknowledge Queensland State Laws will accept this communication as containing my signature within the meaning of the Electronic Transactions (Queensland) Act 2001.

Signature

I agree with the declaration *

Full name of applicant *

Date

Form process

After submitting this form, a Council officer will contact you to discuss times, dates and safety protocols. This usually occurs within three working days.

Please ensure you have read the baiting regulations on our ' Pest animals and approved baiting program' article.

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