Research Permit Request Please review the information on the Research Permits page before proceeding with your application. If you do not receive a response within 5 work days, please email email@example.com. Applicant informationName * Required First Last Date of application - must be mm/dd/yyyy format * Required Institution / department * RequiredAddress * RequiredCity * RequiredState * RequiredZip code * RequiredPhone (###) ###-#### * RequiredEmail * Required Permit informationPermit type * RequiredClass projectGraduate programFaculty researchArboretum program researchOther Other Class no. * RequiredBIO 152BOT 240HORT / LAND ARC 263FW ECOL / PL PATH 309ENVIR ST 361ENVIR ST 375FW ECOL 375BOT 401FW ECOL 410BOT / FW ECOL 455BOT / FW ECOL / ZOO 460Zoology 511FW ECOL 550FW ECOL 561FW ECOL 599SOIL SCI 601BOT / FW ECOL / ZOO 699FW ECOL 875Other Other Instructor * RequiredDegree program * RequiredMSPhDOther Other Graduate dept. * RequiredAgronomyBotanyEntomologyForest & Wildlife EcologyHorticultureLandscape ArchitectureNelson Institute for Environmental StudiesSoil ScienceZoologyOther Other Funding * RequiredIs this a funded project?YesNoSource of funds * RequiredAdvisor * RequiredTimelineProposed start date - must be mm/dd/yyyy format * Required Proposed end date - must be mm/dd/yyyy format * Required Submission deadline - must be mm/dd/yyyy formatProvide the date by which you will submit all data to the Arboretum. VehicleVehicle use * RequiredAre you requesting use of your personal vehicle on Arboretum firelanes?YesNoVehicle information * RequiredVehicle yearMakeModelLicense plate #Add or remove rowProject informationProject title * RequiredProvide a title for your project. Description * RequiredDescribe the project and note any benefits to the Arboretum.Impact * RequiredIndicate any potential negative impact on Arboretum land.Location * RequiredCheck all that apply. UW–Madison Arboretum (Dane County) Abraham's Woods (Green County) Bolz Prairie (Dane County) Faville Prairie (Jefferson County) Finnerud Forest (Oneida County) Hub City Bog (Richland County) Lodde's Mill Bluff (Sauk County) Observatory Woods (Dane County) Oliver Prairie (Green County) Pasque Flower Hill (Dane County) Location details * RequiredProvide additional location details, including research unit (see map) and a detailed description, if known.Structures * RequiredDescribe any structures to be left on site during research (e.g., posts, flagging, data logger) and for how long. Indicate flag color and removal date. Note: Researchers are responsible for removal of all structures when research is completed.Precautions * RequiredDescribe precautions you will take to minimize impact on Arboretum resources.Management restrictions * RequiredAs a site of ecological restoration, Arboretum land management includes invasive species treatment and removal, tree and brush removal, prescribed fire, seed collection, planting and seeding, mowing, and other activities. Do you have concerns that management activities might interfere with your research project? NoYesRestrictions requestIf yes, please let us know which activities you might want restricted in your project area. We will do our best to accommodate requests. We will discuss options with you if a request looks like it will conflict with our management plans. Please email firstname.lastname@example.org with questions. Permit termsBy signing below you agree to do the following (more information is on the Research Permits page): • put name and permit number on all structures • help steward Arboretum lands and report any concerns during the project • carry your permit while in the field • if requested, participate in annual Arboretum Research Symposium • for multi-year projects, submit a brief progress report by November 1 of each year • provide data, metadata, photos of research activities, and resulting papers and presentations to the Arboretum.Photo permission I grant the Arboretum permission to use my photos in publications and informational materials. Agreement * Required I agree to the terms of this permit. Signature * Required(Enter full name) Date - must be mm/dd/yyyy format * Required NameThis field is for validation purposes and should be left unchanged.