Application for Fruit Picking Work and Accommodation

The Depot at Nyah

2921 Murray Valley Highway, Nyah, Victoria, Australia 3594
Register for Accommodation and Work

Fill the form below accurately indicating your details and approximate arrival and departure dates
The information provided in this application shall not be shared to anyone else and is kept confidential.

Fields marked with an * are mandatory and must be supplied.
Name

First NameLast Name
Email*
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Application Type*

Enquiry onlyRegister for AccommodationRegister for Work and Accommodation
Arrival and Departure
Phone Number
Alternate Phone Number
Comments
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Date of Birth

DayMonthYear
Nationality*
Passport Number
Drivers License

NumberState / Country
Vehicle Registration

NumberState
Details for employment
Tax File Number
Visa Expiry Date

DayMonthYear
Work Visa Number
Are you a student for tax purposes

YesNo
Medical Conditions
Submit my application
The information I have supplied on this form is true and correct

Yes
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Register for Accommodation and Work