Animal Survey Form Please fill out the fields below to submit rare animal observation and email photographic documentation (images of animals/habitat/ or maps) to natural.heritage@ncdcr.gov. Be sure to include your name and date of form submission in the email so we can match them to your rare animal report. Fields marked with an asterisk (*) are required. Indicates required field Person Making this Report (Name) Person Making this Report (Name) First Name Last Name Agency/Affiliation Email Address Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number Scientific Name Common Name Observer(s) Date(s) of Observation County Exact Location: Please provide lat/long in addition to detailed location information. Lat/long can be generated from Google Maps - on a computer, click slowly once or twice on the location and a pin will be added with lat/long included. On a smart phone, press and hold on the location, and a red pin will be added and the lat/long will show in the search bar. Number of Animals (include age and sex, if known) Type of Observation (sight record, vocal record, specimen, photograph, etc.) Behavior of Animals (singing, foraging, at nest, etc.) Habitat (use NC NHP natural community name if known; describe dominant vegetation, maturity of vegetation, slope, aspect, etc.) Owners of Land, if Known Other Information
Animal Survey Form Please fill out the fields below to submit rare animal observation and email photographic documentation (images of animals/habitat/ or maps) to natural.heritage@ncdcr.gov. Be sure to include your name and date of form submission in the email so we can match them to your rare animal report. Fields marked with an asterisk (*) are required. Indicates required field Person Making this Report (Name) Person Making this Report (Name) First Name Last Name Agency/Affiliation Email Address Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number Scientific Name Common Name Observer(s) Date(s) of Observation County Exact Location: Please provide lat/long in addition to detailed location information. Lat/long can be generated from Google Maps - on a computer, click slowly once or twice on the location and a pin will be added with lat/long included. On a smart phone, press and hold on the location, and a red pin will be added and the lat/long will show in the search bar. Number of Animals (include age and sex, if known) Type of Observation (sight record, vocal record, specimen, photograph, etc.) Behavior of Animals (singing, foraging, at nest, etc.) Habitat (use NC NHP natural community name if known; describe dominant vegetation, maturity of vegetation, slope, aspect, etc.) Owners of Land, if Known Other Information
