Wisconsin Rare Mammal Observation Form

Notice: The Department cannot process your observation unless you provide complete information. Personally identifiable information will be used to process your observation and may also be used for participation in surveys and other secondary purposes. Information may also be provided to requesters as required under Wisconsin's Open Records Law [ss. 19.31 - 19.39, Wis. Stats.]
For any inquires regarding this form, please contact Adrian Wydeven, 875 S 4th Avenue, Park Falls, Wisconsin, 54552-1130; (715) 762-1363.

Description of Animal
Species:
* If other, please specify:
Number of adults:
Number of young:
Sex:
Estimated size:
Tail Length:
Track Length:
Track Width:
Coloration:
Other Descriptions:
Photo Taken:	Yes No
General Comments:

Location
Latitude:
Longitude:
Section:
Township:	N
Range:	E W
County:
Nearest Intersection:
Direction & Distance From Intersection:
Nearest Town:
Habitat:
Date: (mm/dd/yyyy)
Time: (hh:mm am/pm)

Observer
First Name:
Last Name:
Organization:
E-Mail:
Address:

Phone:
Observer's Background:

If you experience problems using this form, please email Dawn Hinebaugh.

Last Revised: July 13, 2007

Wisconsin Rare Mammal Observation Form

Description of Animal

Location

Observer