Michigan Odonata Survey
Participant Registration Form

Please print this form and mail to the address at the bottom of the page

Name__________________________________________  Date ___________
 
 
Address_________________________________________________________
 
 
________________________________________________________________
 
 
City _________________________ State ______  Zip _______________
 
 
Phone ___________________________  Fax _________________________
 
 
e-mail _______________________________

 

Please indicate your areas of interest and expertise:

 

 

 

How would you like to assist the MOS?
[ ] Survey targeted areas or monitor areas for targeted species
[ ] Collect in various areas anywhere in the state
[ ] Provide data from personal and/or instututional collections
[ ] Data entry volunteer
[ ] Assist with newsletter and other reports
[ ] Verify identifications of ____________________________________
[ ] Photograph various species and habitats
[ ] Other activities:

Please write any additional comments on the reverse side.

Return this to: Michigan Odonata Survey,
c/o Insect Division, Museum of Zoology,
The University of Michigan,
Ann Arbor, MI 48109-1079
fax: 734-763-4080