LAND FOR WILDLIFE
LANDHOLDER EXPRESSION OF INTEREST FORM
A.
ESSENTIAL
CONTACT
DETAILS
Owners Names
Please indicate or include name of contact person/s
Property Name &
Address
Postal Address
(if different)
or extra phone N
o
.s
Telephone
(H)
FAX
(W)
E
-
mail
(mob)
Site visit
Yes, I am interested in receiving free on site advice on managing part of my land as
habitat for native plants and
animals.
I understand that my Assessment will be done as
resources
permit
Mail list
Y
es, I would like to be included on the mail list for
LFW
newsletters and other information
.
B.
OTHER PROPERTY DETAILS
Not essential
-
These details help us pr
epare for your site visit
.
Lot and DP
(If available))
Lot or Portion N
o
.
D.P. Number
Parish and County
(if known)
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
Are
a of property with native vegetation
ha
(1 acre = 0.405ha, 1ha = 10 000m
2
)
(including areas of trees, native grassland etc.)
Local council area
Name:
___________
______________________
Subcatchment
eg Fires Ck, Bunning Ck
NRM Region (CMA)
_________________________________
N.B.
The information y
ou
provide will be used in accordance with the Privacy & Protection of
Personal Information Act 1998. All information that is
collected
can & will only be used for project administration. It cannot be
given to any other party without your permission.
If yo
u are concerned about
how this information may be used we will be happy to discuss it with you.
Please complete the other side...
Ret
urn form to: PO Box 149 Ourimbah 2258
Fax: 4349 4755 Email:landforwildlife@cen.org.au Phone: 4349 475
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C. YOUR INTERESTS
Not essential
-
These details help us prepare for your site visit
..
The Land for Wildlife program aims to help landhold
ers look after natural vegetation on their lands. Participation 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 la
nd. We can also provide you with advice on incentive programs designed to
help landholders and protect vegetation. Other opportunities include workshops, training, networking with other landholders,
help with plants, bush regeneration (depending on availab
ility) and advice / help regarding funding opportunities.
1. Conservation
Incentives
Are you aware of conservation incentive programs for private landholders?
YES / NO
Are you interested in conservation incentive programs?
YES / NO
Are you curre
ntly involved in a conservation incentive program?
YES / NO
If yes, which one/s?
2. Reason for
Interest:
I would like advice on:
(please tick)
Weed control / weed management
Weed identification
Native plant identification
Providi
ng habitat for wildlife
Habitat assessment of my property
Seed collection and propagation
Supply of locally native plants
Property management advice
Other
_________________________________________________
What are the main values of your land to you?
___
____________________________________________________________________
_____________________________________________________________________________________________________________________________
__________________
Why do you think your land is valuable as w
ildlife habitat? _____________________________
______________________________________________________________________________
5. Property Sketch
Draw a sketch of
your property
showing:
•major roads
•boundaries
†
疋敮楮
•buildings / house
•major
污畳
†
牯楮牡穩
†
整
•areas you to
†
牥污禾敧敮敲攠
•corridors /
†
牯潳敤潲物摯
•
潣睡敲楮
†
潩
•
牥潦楶
†
癥来楯漠
†
牯散禾敳潲
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.
Return form to: PO Box 149 Ourimbah 2258 Fax: 4349 4755 Email:landforwildlife@cen.org.au Ph: 4349 475
6