Area of Interest:
Water Quality Monitoring
Invasive Plant Patrol
Brackett Environmental Center

Full Name:

Street Address/PO Box:

Town: State: Zip:

Telephone: Fax:

E-mail:

If you are a seasonal resident, please indicate your winter info:
Address/PO Box:
Town:
State: Winter Zip:
Telephone:

What lake(s) are you interested in monitoring?

Town and County of the lake:

Do you have access to a boat? Yes    No

Are you willing to make a multiple-year commitment to the program?  Yes   No

Please indicate when you will be available to start: