Type of applicant:
Individual:[] | Family:[] | Organization:[] |
Contact:
Contact name:*_____________ Occupation:_______________________
Mailing address:
Street: *_______________ City: *_______________
State: * _______________ Zip: * __________
Email:_______________ Phone:_____________
How did you hear about the Adopt a Crested Saguaro Program?
________________________________________________________
Geographical area of interest (check all that apply)
Cochise Co:[] | Gila Co:[] | Graham Co:[] | Maricopa Co:[] |
Mohave Co:[] | Pima Co:[] | Pinal Co:[] | Yavapai Co:[] |
Yuma Co:[] | Other:_____ |
To access your adopted crested saguaro are you willing and able to drive one-way:
Up to 20 miles:[] | Up to 50 miles:[] | 100 miles or more:[] |
Then hike one-way:
No drive only:[] | Up to one half mile:[] | Up to 2 miles:[] | 5 miles or more:[] |
Not required, but useful, do you own:
Digital camera:[] | GPS device:[] |
Applicant signature:___________________ Date: *_____________
Mail to: Harry Ford, P.O. Box 8250, Tucson, Arizona 85738-0250 or
(prefered) Copy this form and send to: