Aquatic Invasive Species (AIS) Data Collection Form
Date: yyyy/mm/dd   Please enter date of entry.
Time: (hh:mm) :
Your name:
Please enter your first name.
Please enter your last name. 		 
  (first name) (last name)  
Mailing address:
(street) (city) (state) ZIP code
Phone #: Email address:
  (xxx) xxx-xxx)  
Name of lake: Please enter name of lake.
    (nearest city) (state)  
If you have a GPS, please enter the sample coordinates below:
Please set your GPS at NAD83 (ex., N48.37827, W114.36475)
Location:   Decimal

OR

   Deg Min Sec
Latitude Latitude
Longitude Longitude

Description of location and substrates (if known) examined
Substrate type: Boulder Artificial
Method of survey: Scuba
How much time did you spend searching this location?
(to be used as a cost share for future grants)		 Time: (hh:mm) :
Which of the followng species were found?  

Zebra mussel
(Dressiena polymorpha)
Quagga mussel
(Dreissena rostriformis bugensis)


Eurasian Watermilfoil
(Myriophyllum spicatum L.)


Other species
Please describe below:


Flowering Rush
(Butomus umbellatus L.)
New Zealand Mudsnail
(Potamopyrgus antipodarum)

Comments:
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