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 contact Brad Herrick. 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 informationDescription * RequiredDescribe the project and note any benefits to the Arboretum.Impact * RequiredIndicate any potential negative impact on Arboretum land.Location * RequiredCheck all that apply. Arboretum Abraham's Woods Bolz Prairie Faville Prairie Finnerud Forest Hub City Bog Lodde's Mill Bluff Observatory Woods Oliver Prairie Pasque Flower Hill Location details * RequiredProvide additional location details, including management unit (see map [link TK]) and a detailed description or GPS coordinates if available. (GPS units and assistance are available.)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.Permit termsBy signing below you agree to do the following (more information is on the Research Permits page): • provide data and photos collected during this project, and resulting papers/presentations, to the Arboretum. • submit an annual progress report • provide an abstract, investigator names, and other documenting materials for use in the Arboretum's research report • participate in Science Day • help steward Arboretum lands and report any concerns during the project • put name and permit number on all structuresPhoto 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 PhoneThis field is for validation purposes and should be left unchanged.