Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the habitat address the same as above?
*
Yes
No
Type of Habitat Location
*
Home
School
Business
Other
Habitat Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Habitat Checklist
Check all that apply (minimum 3)
*
Water Feature
Nesting Boxes
Pollinator Garden
Bird Feeder(s)
Upload Photo of One Feature (JPG or PNG)
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Choose a file
Cancel
of
Click all that apply (minimum 3)
*
30+ feet canopy, with a portion consisting of native plants
3-5 different levels of vegetation
Few or no exotic or invasive plants
Native plants
Upload Photo of One Feature (JPG or PNG)
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Choose a file
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of
Click all that apply (minimum 3)
*
Install a rain barrel
Nix Pesticides, or practice Integrated Pest Management (IPM)
Restore soil
Reduce or eliminate outdoor lighting
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