RETURN FORM to
:
Land for Wildlife Project C/- Stacey Tyack, Great Lak
es Council, PO Box 450 Forster NSW 2428
ENQUIRIES: Phone
02 6591 7378
Fax
02 6591 7200
Email
Stacey.Tyack@greatlakes.nsw.gov.au
LAND FOR WILDLIFE
LANDHOLDER EXPRESSION OF INTEREST FORM
LANDHOLDER EXPRESSION OF INTEREST FORM
LANDHOLDER EXPRESSION OF INTEREST FORM
LANDHOLDER EXPRESSION OF INTEREST FORM
A.
A.A.
A.
ESSENTIAL
ESSENTIAL
ESSENTIAL
ESSENTIAL
CONTACT
CONTACT
CONTACT
CONTACT
DETAILS
DETAILS
DETAILS
DETAILS
Date:
_________________
Owners Names
Contact Name
Property Name &
Address
Postal Address
(if different)
or extra phone N
o
.s
(H) Fax
(W)
Telephone
(mob)
E-mail
Site visit
Yes, I am interested in receiving free on site advi
ce on managing part of my land as
habitat for native plants and animals.
Mail list
Yes, I would like to be informed of workshops, prope
rty open days and other project
events, by: post
post
post
post / email only
email only
email only
email only / either
either
either
either (please circle one)
Yes, I would like to be included on the mail list for
CEN newsletters and other
information.
B.
B.B.
B.
OTHER PROPERTY DETAILS
OTHER PROPERTY DETAILS
OTHER PROPERTY DETAILS
OTHER PROPERTY DETAILS
Lot or Portion N
o
. D.P. Number Parish and County
(if known)
Lot and DP
The Lot and DP enable us to prepare a base map and
vegetation community map to bring to the site visit.
Area of property ha
Area of property with native vegetation
ha
(1 acre = 0.405ha, 1h
a = 10 000m
2
)
(including areas of trees, native grassland etc.)
Local council area
Great Lakes
Gloucester
Greater Taree
Other
______________________
Subcatchment
eg Fires Ck, Bunning Ck
NRM Region (CMA)
Hunter Central Rivers CMA
Other local interest groups
(eg: birdwatching, Landcare, bushwalking, etc)
Please complete the other side...
RETURN FORM to
:
Land for Wildlife Project C/- Stacey Tyack, Great Lak
es Council, PO Box 450 Forster NSW 2428
ENQUIRIES: Phone
02 6591 7378
Fax
02 6591 7200
Email
Stacey.Tyack@greatlakes.nsw.gov.au
C. YOUR INTERESTS
C. YOUR INTERESTS
C. YOUR INTERESTS
C. YOUR INTERESTS
Not essential - These details help us prepare for y
our site visit
..
The Land for Wildlife program aims to help landhold
ers look after natural vegetation on their lands. Pa
rticipation in this project
is entirely voluntary. We can assist you by visiting
your property, giving you advice on the natural values
of your property and
how you can manage the natural areas on your land. Oth
er opportunities include workshops, training, network
ing with other
landholders, help with plants, bush regeneration (d
epending on availability) and advice/help regarding
funding opportunities.
I would like
I would like
I would like
I would like further
further
further
further advice on:
advice on:
advice on:
advice on:
(please tick)
Weed control / weed management
Weed identification
Native plant identification
Providing habitat for wildlife
Habitat assessment of my property
Seed collection and propagation
Supply of locally native plants
Property management advice
Other
1. Reason for
Interest:
What are the main values of your land to you?
Why do you think your land is valuable as wildlife
habitat?
2. Email Contact
List:
I would like to join an email events/information li
st. This list is used for advertising workshops,
information days, etc. My email address is:
3. Property Sketch
Draw a basic sketch
of your property
showing:
areas you plan to
replant/regenerate
corridors/proposed
corridor
showing the area of
native vegetation
you wish to
protect/restore
N
..
If there is any additional information you would like
to provide on your land or why you are interested in
the program you may
attach a separate sheet.
N.B. Involvement in the Conservation on Private Lan
ds Project does not change the legal status of your
property. The information you provide will be used
in
accordance with the Privacy & Protection of Persona
l Information Act 1998. All information that is colle
cted can & will only be used for project administra
tion. It
cannot be given to any other party without your per
mission. If you are concerned about how this inform
ation may be used we will be happy to discuss it wi
th you.