| NOMINATOR INFORMATION |
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Nominator Name: |
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Organization: |
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| Address: |
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| City, State, Zip: |
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| Email: |
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Phone:
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Date:
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| SITE INFORMATION |
| Site Name: |
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| Address: |
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| City, State, Zip: |
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| Phone: |
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FAX:
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Size (acres):
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| Website URL: |
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Directions to site:
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General description
of site:
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| SPECIES / HABITAT INFORMATION |
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Signature species (bird/wildlife)
this site is known for: | |
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Rare species (bird/wildlife)
found at this site: | |
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Habitats (lakes, rivers, forest,
wetlands, bogs, grassland, etc.): | |
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| SITE ACCESS INFORMATION |
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Admission charges:
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Hours of operation:
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Seasonality of site:
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Site restrictions: |
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| SITE ASSESSMENT INFORMATION |
Amenities: |
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parking areas |
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restrooms
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drinking fountain
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gravel trails
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boardwalks
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viewing platform/observation blind
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wildlife viewing window
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visitors center
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gift shop/book store
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equipment loans
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handicap accessible |
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other
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Activities: |
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camping
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swimming
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biking
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cultural attraction
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other
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Food and lodging within
10 miles of site:
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Historical/cultural attributes
at or near site:
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Any other notable reasons
to visit site:
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Please check over your nomination information in the new window. 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. |
