WI IBA Nomination Form

NOMINATION FORM

The Wisconsin Bird Conservation Initiative (WBCI) is conducting an inventory of areas that may qualify as Important Bird Areas (IBAs). A Technical Committee composed of various experts across Wisconsin has determined qualifying criteria and will review all nominated sites. To qualify, an area needs to meet only one of the IBA critera, although many areas will meet several. Please tell us about areas that you think may meet the criteria by completing as much of this form as possible.

Please read the instructions carefully before completing this form. If you need more information or assistance, please contact Yoyi Steele, IBA Coordinator for Wisconsin, 101 S. Webster St., WM/4, P.O. Box 7921, Madison, WI 53707-7921, Phone: 608-266-8169, Fax: 608-267-7857, yoyi.steele@dnr.state.wi.us.

PERSONAL INFORMATION

FIRST NAME:
LAST NAME:
ADDRESS:

CITY:
STATE:	ZIP:

	PHONE:
	EMAIL:
	FAX:
	AFFILIATION:
	DATE:

SITE INFORMATION

SITE NAME:		SITE SIZE:	acres
TOWNS:		ELEVATION:	feet
COUNTIES:
CENTER OF SITE	LATITUDE: degrees minutes LONGITUDE: degrees minutes
	TOWNSHIP: RANGE: SECTION:

GENERAL DESCRIPTION OF SITE:
(general habitat, location, prominent features, access and facilities, and any other helpful information).

IBA SITE CRITERIA

PLEASE REFER TO THE DETAILED DESCRIPTIONS OF CRITERIA BEFORE COMPLETING THIS SECTION.
Check all that apply.

	WI-1. Site is important to one or more species listed as endangered or threatened in Wisconsin.
	WI-2. Site is important to one or more species identified as high conservation priorities in Wisconsin.
	WI-3. Site harbors an assemblage of species associated with a habitat type that is representative, rare, or threatened in Wisconsin.
	WI-4a. Site where significant numbers of single species concentrate for breeding, migration/staging, or wintering.
	WI-4b. Site where significant numbers of waterfowl concentrate for breeding, migration/staging, or wintering.
	WI-4c. Site where significant numbers of shorebirds concentrate for breeding, migration/staging, or wintering.
	WI-4d. Site where significant numbers of waterbirds concentrate for breeding, migration/staging, or wintering.
	WI-4e. Site where significant numbers of landbirds and raptors concentrate for breeding, migration/staging, or wintering.
	WI-5. Site is important for long-term research and/or monitoring projects that contribute substantially to ornithology, bird conservation and/or education.

WHY IS THIS SITE IMPORTANT FOR WISCONSIN'S BIRDS? Please provide an explanation for each category checked above.

ORNITHOLOGICAL IMPORTANCE

Please list the criteria you are providing data for, the species this site is important for, the season(s) for which the site is important, maximum daily numbers, the years on which this count estimate is based, and the accuracy of the data. If you need additional space, you may use the Other Remarks text box at the end of the form.

CRITERIA	SPECIES	SEASON	MAX. DAILY NUMBERS/SEASON	YEARS	ACCURACY

SEASON (on which quantitative data are based): B=Breeding, W=Winter, SM=Spring Migration, FM=Fall Migration.
MAX. DAILY NUMBERS/SEASON For hawk migration sites, specify total numbers over the season if known; for other sites, specify daily numbers only.
ACCURACY How sure are you of these data? 1=Rough estimate, 2=Good estimate, 3=Accurate count or estimate.

DATA SOURCES (Examples: Breeding Bird Survey, Christmas Bird Count, personal observation, etc. If published, please provide author, date, title, publication, and page number).

HABITAT AND LAND USE

Major Habitat Types: indicate approximate % of total area of site.
	Upland Hardwood Forest (aspen, maple, birch, oak, etc.)
	Upland Coniferous Forest (hemlock, pine, spruce, etc.)
	Upland Mixed Hardwood-Coniferous Forest
	Lowland Hardwood Forest (ash, maple, cottonwood, etc.)
	Lowland Coniferous Forest (cedar, spruce, tamarack, etc.)
	Lowland Mixed Hardwood-Coniferous Forest
	Hardwood or Conifer Plantation
	Upland Shrub
	Oak Savanna / Barrens
	Conifer Barrens
	Prairie
	Oldfield
	Grass / Hay Field
	Agricultural Field
	Open Bog / Sedge Meadow / Wetland
	Shrub Swamp
	Pond / Lake
	Stream / River
	Urban / Suburban
	Other (specify)

Major Land Uses: check all major land uses
	Nature / Wildlife Conservation
	Hunting / Fishing
	Other Recreation / Tourism
	Agriculture / Livestock
	Forestry
	Water Supply
	Utility / Right-of-way
	Suburban / Residential
	Urban / Industrial / Commercial
	Military
	Research
Other (specify)

Land Ownership/Management: check all that apply
	State
	Federal
	Municipal
	County
	Private (individual)
	Private (industrial)
	Non-Governmental Organization

CONSERVATION AND OTHER

Primary Conservation Issues: Please note Serious (S), Minor (M), and Potential (P) threats to the site.

	Invasive or non-native plants
	Introduced animals or feral/free-ranging house cats
	Pests / Diseases
	Cowbird Parasitism
	Succession
	Deforestation / Tree cutting
	Overgrazing / Overbrowsing
	Predators
	Pesticides
	Agricultural use / Intensity
	Water pollution / Air pollution

	Excessive soil erosion / Degradation
	Extraction industry
	Habitat conversion
	Residential / Commercial development
	Communication / Wind towers / Power lines
	Disturbance to birds or habitat
	Recreational development / Overuse
	Hydrologic changes (drainage, damming, etc.)
	Illegal take / Vandalism
	Population / Genetic factors
	Habitat fragmentation / Degradation

DESCRIBE these issues, their seriousness, and steps being taken to address them:

STAKEHOLDER GROUPS

Please provide the contact information for existing or potential groups (or individuals) with an interest in this site. If you have additional stakeholder groups, you may include them in the Other Remarks text box at the end of the form.

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:

LANDOWNER / LAND MANAGER CONTACTS

Please refer to the Land Ownership / Land Management Guidelines before completing this section. Please provide the name(s), address(es), and phone number(s) of the landowner(s) or land manager(s) for the site, and indicate whether they have been contacted concerning the nomination of the site. If you have additional landowner/land manager contacts, you may included them in the Other Remarks text box at the end of the form.

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:
CONTACTED? No Yes

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:
CONTACTED? No Yes

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:
CONTACTED? No Yes

NAME:
ADDRESS:
CITY:
STATE:	ZIP:
PHONE:
EMAIL:
CONTACTED? No Yes

PLEASE DESCRIBE ANY IMPORTANT, RARE, OR UNUSUAL FLORA, NON-AVIAN FAUNA, WATCHABLE WILDLIFE, AND/OR HABITATS ASSOCIATED WITH SITE:

PLEASE DESCRIBE ANY SOCIAL, CULTURAL, ECONOMIC, OR HISTORIC ISSUES ASSOCIATED WITH SITE:

SUPPORTING DOCUMENTATION (maps, photos, field notes, checklists, etc.) sent separately by regular mail:

OTHER REMARKS (including any additional information you were unable to include elsewhere on this form):

Your nomination information will appear in a new window. Your browser must be JavaScript enabled and allow pop-up windows. Please check over your nomination. If you are satisifed, print a copy of your nomination for your records then click the Final Submit button. If you want to make changes to your nomination information, simply close the new window and return to this form.