Provenance Registration Register for your Unique Provenance Identifier (UPI) SECTION 1 — MAKER IDENTITYName(Required) First Last Business or Trading name(Required)Studio /Property/Farm NameYour Maker StoryWrite 2–3 sentences describing your practice, your materials, and your region. This text will appear as your provenance narrative on your Digital Product Passport and Southern Cross Registry profile. Example: ‘I am a hand-weaver based in Geelong, Victoria, working with Australian Merino wool sourced from the Western District. My practice draws on traditional twill structures adapted for contemporary textile design.ABN(Required)Email(Required) PhoneAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country SECTION 2 — GEOGRAPHIC ORIGINRegion or area of productionThe specific region, valley, district or area where your work is produced. This is essential for provenance verification.Is your production located on a named property or farm? Yes No Other SECTION 3 — PRODUCTION METHODMaker or Producer TypeFibre producer – farmer or growerHand spinnerWeaver or cloth makerMill or Finisher – washing, pressing, finishingDesignerBrandTextile or Fibre ArtistNatural DyerMakerDescribe your production methodDescribe your production method — i.e How is your work made? Include process, technique, and equipment used.Is your production entirely by hand, assisted by tools, or mechanical? Entirely by hand With assistance of tools Mechanical with significant manual work Are any production steps carried out outside Australia? Yes No Describe the offshore steps and locationDescribe what happens offshore, where it occurs, and which part of your production it covers. For example: spinning — Cambodia. Dyeing — Italy.Upload any documentation supporting your production method declaration Drop files here or Select files Accepted file types: acceptedformats:pdf, jpg, pngmaximumfilesize:10mb, Max. file size: 2 GB. For example, workshop photographs, guild membership, heritage skills documentation, or other evidence of your practice.SECTION 4 — FIBRE OR MATERIAL CONTENTPrimary fibre or material(Required)e.g. Merino wool, silk, cotton, linen, leather, clayFibre or material grade or specificatione.g. 18.5 micron, Grade A, organicDo you hold a third party certificate for your fibre or material? Yes No Certifying body and certificate numberCertificate | File upload Drop files here or Select files Max. file size: 2 GB. Please upload any relevant certificates or documentation supporting your registration — for example, your Australian Wool Testing Authority test certificate, organic certification, Responsible Wool Standard certificate, or other third party verification. Accepted formats: PDF, JPG, PNG.Where does your fibre or material originate?Name the farm, region, or country of origin for your primary material.SECTION 5 — CHAIN OF CUSTODYDoes your work form part of a provenance chain with other Chain Members? Yes No Other A Chain Member is anyone registered with the Southern Cross Registry who holds a Unique Provenance Identifier, whose work connects to yours — either as a source of your materials, or as someone who uses your work in their own production.If yes, what is their UPI or business name ?If your source is already registered with the Southern Cross Registry, enter their Unique Provenance Identifier here.Existing certifications held Australian Wool Testing Authority (AWTA) certificate Responsible Wool Standard (RWS) certification RSPCA Approved Farming certification Certified organic — please specify certifying body Other — please specify None UPI NumberYou do not need to fill this in. Your Unique Provenance Identifier will be automatically generated and emailed to you upon submission.SECTION 6 — DECLARATIONI declare the information provided is accurate and complete Yes I declare that all information provided in this registration form is accurate, complete, and not misleading. I understand that CWA relies on the accuracy of this declaration without independent verification, and that the accuracy of my registration data is my sole responsibility.I agree to the Rules Governing Use of the Southern Cross Registry Yes I have read and agree to be bound by the Southern Cross Registry Terms of Registration (CWA-REG-001), including the Rules Governing Use of the Southern Cross Registry. Δ