Chimney Swift Structure Report

Chimney or Swift Tower Report Form
Nest or Roost Type

Other
Coordinates
Latitude, Longitude of the sighting
Click here to find coordinates (opens in a new window)
Use Type
Chimney condition
How many swifts
Comments
Upload Photo(s)

Browse Files
Photos really help! Cancelof
Your Information
Name
E-mail
Phone Number
Format: 000-000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Chimney or Tower Owner Information
Owner
Property Type
Property Name
Name of school, factory, other facility
Display on map (towers only)
Do you give permission to have the tower location displayed on a map?
Public Access (towers only)
Will you allow the public to view the swifts?
MBCP Access
Can a trained Chimney Swift Program volunteer observe swifts on the property?
** Skip to SUBMIT if you selected "Same as observer" for the Owner **
Owner Name
Owner Address

Street Address

Street Address Line 2

CityState

Zip Code
Owner Email
example@example.com
Owner Phone
Format: 000-000-0000.
Should be Empty:

Chimney or Swift Tower Report Form