Habitat Components

Registry of Nature Habitats Certification Application

Please answer all questions. Your admitance into the registry will be determined by the overall habitat of your property. Once the application is completed, you will need to send us via email or post office, pictures of your property. These pictures need to contain the structural and plant components of your property you checked or listed in this application. If you wish to have these pictures returned, send a stamped return address envelope with them. It is very important to be very specific with your general view on nature and the enviroment. If your property is admitted, you will be listed in the database. Each property admitted into the registry will have a webpage displaying the pictures and information provided below.

*First Name*	*Last Name*
*County*	*Mailing Address*
*Street Address*	*City*
*State*	*Zip*
*E-mail*	*Phone*
*Fax*	Property Size ( Sq. Ft. or acres)
*List Deciduous Trees*	*List Conifers*

*List Flowering Trees*	*List Shrubs*

*List Perennials*	*List Native Wildflowers, Ferns, Woodland Plants, Etc...*

*Check all natural feed sources found on your property.* Nuts Berries Seeds Fruits Nectar Foliage Pollen	*Check all the water sources found on your property.* Pond Stream/River Wetlands Coastal/Sea Shore Lake or Lake Front natural Springs Bird Baths
*Check all natural cover locations for birds and animals.* Wooded Areas Thick Ground Covers Brush Piles Rock Walls Dense Shrubs/Thickets Evergreens Bramble Patch Meadows/Prairie or Scrub Wood or Log Piles	Check all nesting locations for birds and animals. Mature Trees Dense Shrubs Scrub Dead Trees/Trees with Cavities *Do you provide:* Nest Boxes for Birds Butterfly Houses Bee Hives/Housing Bat Houses
*Check the seeds/food you provide.* Sunflower Seeds Millet Corn (Cracked or Whole) Thistle Safflower Suet Fruit Peanuts Sugar Water (Hummingbirds & Orioles) *List Others Below:*	*What type of feeders do you provide.* Hoppers Tube Cage Hummingbird/Oriole Suet Tray Window Squirrel/Chipmunk Insect *List Others Below:*
*List Birds seen on your Property.* Blackbirds/Grackles/Crows Sparrows Titmouse/Cardinals/Chickadee Finches Woodpeckers/Nuthatch Warblers Hummingbirds Orioles Turkey/Grouse/Pheasant/Quail Seagulls/Terns Ducks/Geese/Swans Hawks/Eagles *List specific birds below:*	*List Mammals seen on your property.* Chipmunks Gray Squirrel Red Squirrel Oppossum Raccoon Mink Otter Beaver Muskrat Mice/Moles/Voles Groundhog Deer Bear Coyote *List other mammals below:*
List Fish found on your property. Trout Bass Salmon Carp Perch *List other fish below:*	List Reptiles found on your property. Snakes Turtles Lizards Alligator *List other reptiles below:*
*List Amphibians found on your property.* Frogs Toads Salamanders List other amphibians below:	*List Insects/Invertebrates found on your property.* Bees/Wasps Spiders Lady Bugs/Lacewing Damselflies Butterflies/Moths *List other insects/invertebrates below:*
*Do you use any of the following non-organic chemicals?* Fertilizers Insect Sprays Weed Killers Fungicides	*Do you use any of the following organic chemicals?* Fertilizers Insect Sprays Weed Killers Fungicides

Please describe your general view on nature and the enviroment.