BirdCount2010 ParticipantAddressFormPSJ 1

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CBC Participant Address Form

Simply click the gray boxes, type in the information, save the form and send it back to
me as an e-mail attachment to alan.knothe@myfwc.com.

Name:

Street Address:

City: State: Zip:

e-mail:

Phone #:

Would you like to receive the Christmas Bird Count issue of North American Birds (there
is no additional charge for this magazine)?
Yes or No

Please indicate your preference for a territory to survey (see the map on the next page to
match a territory with a number. Rank your choices in order of preference. People that
helped with last year’s count will be given preference. After that, it will be first come first
serve.
Territory Leader 1st Choice 2nd Choice 3rd Choice
1. St. Joe Pen. John Murphy 1st Choice 2nd Choice 3rd Choice
State Park
2a. Pig Island Brad Smith 1st Choice 2nd Choice 3rd Choice
Rick West
2b. Cape San Barbara 1st Choice 2nd Choice 3rd Choice
Blas Stedman
3. St. Joe Travis & Karen 1st Choice 2nd Choice 3rd Choice
Buffer Preserve MacClendon
4. Indian Pass Alan Knothe 1st Choice 2nd Choice 3rd Choice
Peninsula
5. Port St. Joe Marvin Collins 1st Choice 2nd Choice 3rd Choice
South
6. Port St. Joe Donna Wells 1st Choice 2nd Choice 3rd Choice

Map on next page

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