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Observer Name
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Address
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City
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State
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Zip Code
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Phone Number
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E-mail Address
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Date Of Observation
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Address Where Observation Occurred
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Distance From Nearest Town
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County
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Land Ownership
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UTM Coordinates (If GPS is available, NAD 27 preferred)
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Latitude/Longitude (If known)
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Habitat Type (Rural, Urban, etc.)
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Nest Type (Stick, Cavity, Ledge, or Burrow)
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Size Of Nest
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Description Of Nest Location
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Bird Species
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Age Of Birds (Adult, Subadult, Fledgling)
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Number Observed
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Behavior Observed
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Proximity To Power Structures (Poles, Lines, etc.)
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Other Comments
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