<p> Registered Chemical Applicator – Application for Revalidation * Items with an asterisk may be published on the GROWSAFE® website register of RCAs.</p><p>Your Details (Home address, email and phone number requested so that we can still contact you in the event you change employer before your next revalidation.)</p><p>First name * </p><p>Second name(s) </p><p>Surname * </p><p>Home address </p><p>Work email address * </p><p>Personal email address</p><p>Work phone number * </p><p>Home phone number</p><p>Mobile phone number * </p><p>Your Company/Employer</p><p>Employer/ company name * </p><p>Physical address (for site visit)</p><p>Postal address (for invoice)</p><p>Company website * </p><p>Main activity* (eg roads and reserves, biosecurity, pastoral weed control)</p><p>Certification Requirements</p><p>GROWSAFE® RCA number* R</p><p>Approved Handler certificate number and expiry date </p>