Please provide as much information as possible:

    Name         Work Phone  

 Address            Home Phone

                                        Fax

 City State Zip     Email

   Date of Observation

    Location    Lat   Lon

    Site Description

     Reason on Site  

    Knowledge of area? First Time Visit Occasionally Visit Frequently       

Observation(s)

Observed Before? Never Occasionally Frequently         If yes, then when?

        If yes, then where?

   Photos or samples taken(describe)?    

Comments regarding this form, the MEERA webpage, or the MEERA project are always welcome!