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Application Form for Professional Users and Distributors of Plant Protection Products

DETAILS OF APPLICATION

Please note that in order for this application to be considered valid, a duly filled copy of the Declaration of the Applicant's Trainer form must be submitted along with this form. A copy of such form may be obtained by clicking here.

APPLICANT DETAILS

Are you a returning user?

A 'returning user' is one who has at least filled in this form once, from the 22nd of July 2020 onwards. If any personal or company details have changed from when you last submitted this form, the you are kindly asked to click 'No'. By clicking 'Yes', you are declaring that you have already provided your personal details in this form, and will therefore be asked for the email address only.

If you are unsure whether you are a returning user or not, you may either click 'No' or else contact the MCCAA for assistance.

Full name

ID card number

Address

Email address

Please check the format of your answer.

Please ensure that the email address is correct as it will be used for acknowledgement purposes and also to get in touch with you.

Contact No.

Only numbers may be entered in this field.

Course start date

Course end date

Course organised by

Certification required for

Choose one of the following answers

Professional user
Distributor

Name & Address of Premises distributing PPPs (Applicable for distributors applying to obtain Distributor Certification of Plant Protection Products in line with SL 430.08)

Name of Premises
Address

Type of certification

Choose one of the following answers

New
Renewal

Passport Photo and Declaration of the Applicant's Trainer

Please upload 2 files

Upload files

Passport photo is required in fulfillment of the issuing of the certification documentation for professional users or distributors for Identification purposes.

This form is to be completed by the Trainer and attached to this application.

PAYMENT DETAILS

Payment (applicable for distributors applying to obtain Distributor Certification of Plant Protection Products in line with SL 430.08):

This application form is required to be submitted to the MCCAA authorised trainer with a payment of €25 (inclusive of VAT) per certificate to be issued

Payment method

Choose one of the following answers

Bank transfer
Cheque (payable to the MCCAA)

Bank Account Details:

Bank name: Bank of Valletta

IBAN number: MT14VALL22013000000040019986609

Swift code: VALLMTMT

DECLARATIONS

Content Declaration

Check all that apply

I, hereby declare that the details furnished in this application are true and correct to the best of my knowledge and belief and I undertake to inform the Malta Competition and Consumer Affairs Authority of any changes therein, immediately. In case any of the above information is found to be false, untrue, misleading or misrepresenting, I am aware that I may be held liable for it. I understand that this form will be considered invalid unless the Declaration of the Applicant's Trainer form is duly filled.

Data Protection Declaration

Check all that apply

The Malta Competition and Consumer Affairs Authority ("the Controller") will process your personal data in accordance with the relevant provisions of the General Data Protection Regulation (GDPR) (Regulation 2106/679) and the Data Protection Act (Chapter 586 of the Laws of Malta), for the purpose of certifying the applicant as a professional user or distributor of plant protection products, in accordance with the relevant provisions of the Sustainable Use of Pesticides Regulations, Subsidiary Legislation 430.08 of the Laws of Malta.I am aware that this requires the disclosure of my name, identification card number, passport photo and contact details for the purpose of providing the required personal data to the Controller for professional user or distrbutor certification purposes. The Controller will process your personal data for administrative purposes and to comply with its legal obligations. For further information on how your personal data will be processed refer to the Controllers's privacy policy.
I, hereby provide my consent to the Controller to process my personal data for the reasons specified in this Declaration.

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