Contact Information:
First Name: ✻
Last Name: ✻
Email Address: ✻
Mailing Address:
Agency or Business:
Street:
City:
State:
Zip Code:
County:
Weed Information
Weed Species:
If other, please describe:
Street Address (if known):
City (if known):
Coordinates (if known):
Latitude:
Longitude:
Type of Location: ✻
Number of Plants (estimate): ✻
Acreage (estimate):
Type of Ownership (if known):
Comments or Location Notes:
