• Aerial Application Request Form

    Aerial Application Request Form

  • Do You Have A Recomendation From An Agronimist? If Yes Please Provide The Recomendation In Full In The Next Section*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Prefered Application Date*
  • Do you confirm all the Details and Maps of this Recomendation Are Correct?*
  • Type Of Application*
  • Preferred Application Date*
  • Water Rate / Ha*
  • Will All Fields Be Treated With The Same Products and Rate?
  • Rows
  • Rows
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • See Below An Example Of A Well Marked Map

  • Image field 57
  • Have You Provided A Map?*
  • Do Any Of The Areas To Be Treated Have Powerlines?*
  • Are There Any Susceptible Crops? If Yes Please Describe In Comments (Relevant for Herbicide Applications)
  • Is There Any Bees, Orgainc Farms Or Aquatic Farms? (If Yes Or Other, Please describe in the comments section at the end)*
  • Is There Any Dwellings withing 150M of the application Area?*
  • Have You Notified Your Neigbours Of The Application?*
  • Is The Product Requested Registered On Label for Aerial Application?*

  • Airstrip Use and Chemical Drop Off

    Please Speak with Adam on 0407 293 218 Or Alex on 0409 339 970 in regards to the Airstrip to be Used where to deliver chemical.
  • I Agree to Hazair's Terms And Conditions Of Aerial Application*
  • Should be Empty: