Instructions: Please submit one copy of this form for each individual species record you wish to have added to the database and web site. Key information is denoted by an asterisk (*) - We especially need you to submit that information. Although not required, we would love to receive photo submissions as well. Thanks!
Submitter Information
*Your Name
*Address
Phone Number
*E-mail Address
Identification Information
*Common Name
Latin Name
*Date of Sighting (mm/dd/yyyy)
Number Sighted
Identifier
Locality Information Must be within Middletown City Limits
*Exact Location of Sighting (Street address, park name, or other designation: descriptions welcome)
Longitude
Latitude
Photographic Information
Attach Photo
Name of Photographer
By clicking submit, you hereby give permission for the Jonah Center and Wesleyan University to reproduce and use the submitted photo on their Web sites, displays, and other materials.