Lake-Wide AIS Treatment Information
Contact Name
*
First Name
Last Name
Organization's Name (if applicable)
Lake Association, Company, Governmental Organization, etc
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Correspondence Preference(s)
*
Email
Phone
Other
County
*
Lake Name
*
Total Lake Size in Acres
*
Enter Numeral
Acres of Treatment Area (if known)
*
Enter Numeral
Past Permit Number (if applicable)
Known Aquatic Invasive Species Targeted
Message/More Information
Submit
Should be Empty: