BICWA FBRP Registration Form

BICWA Farm Business Resilience Program Registration Form

This is an eight week program, with four in-person workshops, and includes business coaching.

It is important that you attend all four days of the in-person training.

Business coaching will be completed virtually.

Dates for the in-person workshops are:

Block 1: 9 - 10 June 2025

Day 1: Strategic planning for your business

Day 2: Innovation, and planning for climate variability

Block 2: 14 - 15 July 2025

Day 3: Benchmarking and financial data driven decision making

Day 4: Building personal and social resilience

Venue: Perth Hills

Participant fee is $500 per participant, with claimable travel of up to $1000 per participant, based on ATO km travel rates. Both costings are inclusive of GST. CONDITIONS APPLY.

If the BICWA Farm Business Resilience Program dates don't suit your calendar and/or you are interested in future programs, please complete the Expression Of Interest form via the link below.

https://form.jotform.com/250557406658060

We will keep you informed of upcoming opportunties.
Do you have 1 or 2 Applicants?*

1 Applicant2 Applicants
Applicant 1
Name:*

First NameLast Name
Date of Birth*

DayMonthYear
Date
E-mail Address:*
Phone Number:*

Area CodePhone Number
Primary Address:*

Street Address

Street Address Line 2

CityState

Postcode
Same as Primary Address
Mailing Address:*

Street Address

Street Address Line 2

CityState

Postcode
Describe your role in the business?*

Applicant 2
Name:*

First NameLast Name
Date of Birth*

MonthDayYear
Date
E-mail Address:*
example@example.com (must be separate to applicant 1)
Phone Number:*

Area CodePhone Number
Same as Primary Address
Primary Address:*

Street Address

Street Address Line 2

CityState

Postcode
Mailing Address:*

Street Address

Street Address Line 2

CityState

Postcode
Describe your role in the business*

Business Details
Business Entity Name*
Local Government Area*
ABN*
Size of Enterprise*
E.g. Number of Hives
Your Farming Operations

% of farm business:
Beekeeping / apiculture
%
Horticulture / vegetables
%
Tourism
%
Viticulture
%
Other (e.g. livestock)
Name and %
Other (e.g. cropping)
Name and %
Other
Name and %

Additional Information
Do you have any dietary needs?*

YesNo
Tick all that apply:

Gluten freeDairy freeVegetarianOther
Do you know someone that would benefit completing the program? Please add their name, email and/or telephone number so we can send them information.

Diploma of Leadership and Management (optional)
Are you interested in attaining the Diploma of Leadership and Management qualification?

YesNoNot Sure
Conditions apply, including attending the full program to be eligible. The fee for this is $5500.

The qualification is an additional offering from Value Creators and their Registered Training Organisation partner, One World Learning. Successful attainment will be based on participation in the entire program and submission of a completed detailed Beekeeper Farm Business Resilience Plan. The customised FBR Program content, from Value Creators aligns with and adheres to the Australian Education Curriculum standards required for a Diploma of Leadership and Management.

The usual value of a Diploma qualification is approximately $7,500. This cost includes the RTO process and compliance to assess each participant against each unit, and their completed farm plans.

Authorisation and Certification
Authority to Share Contract Information and Talent Release

I agree that Value Creators and BICWA may share my contact details, which I have provided to Value Creators and BICWA.

I acknowledge that I will not receive payment or compensation of any kind from Value Creators or BICWA in relation to the sharing of my contact details.

I agree that this Authority to share my contact details is unconditional and irrevocable.

I hereby absolutely and irrevocably indemnify Value Creators Pty Ltd and its employees and all persons acting under its authority from any and all injury, liability and claims, including any indirect and consequential losses, in relation to Value Creators sharing my contact details.

Talent Release

I hereby consent to Value Creators and BICWA making unrestricted use of any recordings of my voice, image and my presentation recorded by Value Creators and BICWA, its employees or contractors.

I agree that Value Creators may:
a) Reproduce and distribute the audio and visual recordings;
b) Transmit and publish the audio in any format and in any publication; and
c) Publish externally any slides/PowerPoint Presentation used in connection with the Event.

I acknowledge that I will not receive payment or compensation of any kind from Value Creators in relation to Value Creators use and publication of the photographs and any recordings.

I agree that this Talent Release Authority is unconditional and irrevocable.

I hereby absolutely and irrevocably indemnify Value Creators Pty Ltd, BICWA and its employees and all persons acting under its authority from any and all injury, liability and claims, including any indirect and consequential losses, in relation to Value Creators use and publication of the pictures and audio.
I/we consent to the above authority to share and talent release form.*

YesNo
Participation Protocols: Terms and Conditions of Participation

The duration of the BICWA Farm Business Resilience Program is 8 weeks. As a Program Participant, you agree to actively participate in the program for the full duration of the program.

• Program Participant agree to be available, responsive to each other’s needs and willing to adjust schedules as necessary.

• As part of the BICWA Farm Business Resilience Program, Program Participant agrees to establish contact with your Mentor and attend any virtual sessions .

• Should either of the parties feel dissatisfied with the other for any reason whatsoever, please let us know by email info@valuecreators.com.au.

Confidentiality/Liability
• Respect the confidentiality of any information shared during the entire program and mentoring relationship (except as required by law)

• Conduct mentoring in an environment that is conducive to confidentiality

• Use appropriate self-disclosure in the mentoring process

• Openly disclose any conflicts of interest

The Business Coach does not accept liability for the consequences of the Participant’s business or life decisions. The Business Coach works on the basis that the participant is fully responsible for his/her own life and decisions. As such, the Business Coach will offer suggestions and share experiences, but any decision about a course of action is ultimately the Participant’s, and Participant’s alone.
I confirm I am authorised to make this Certification.*

YesNo
Name of Person making this Certification*

First NameLast Name
Signature*

Clear

My Products

Deposit - 1 Applicant$500.00AUD

Deposit for 1 Applicant

Deposit - 2 Applicants$1,000.00AUD

Deposit for 2 Applicants

Total $0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

BICWA Farm Business Resilience Program Registration Form

Applicant 1

Applicant 2

Business Details

Your Farming Operations

% of farm business:

Farm business eligibility

Your Strategic Farm Business Planning

Additional Information

Authorisation and Certification