Thank you for your interest in the 2014 Great Cocky Count, which will take place on Sunday 6 April at sunset across southwest Western Australia.
To register for the survey, please complete ALL information and sign below.
· Your home address is necessary so we can allocate you a survey location as close to your home as possible.
· Please provide a phone number. Most contact is by email, but we may need to discuss the survey with you.
· Please provide your home phone number and personal email address if possible so we don’t lose track of you if your place of employment changes.
Dr / Mr / Mrs / Miss / Ms / First Name / SurnameStreet Address / Town/Suburb
State / Post Code / Email
Telephone (home) / Telephone (work) / Telephone (mobile)
2014 Great Cocky Count Health & Safety Information
• We wish to remind you that you are responsible for your own safety while taking part in the roost counts. In addition, you must complete our volunteer registration process before undertaking roost counts.
• Always let someone know when you are going and when you expect to return.
• Wear sturdy, enclosed shoes or walking boots, protective clothing and be prepared for adverse conditions. Carry sufficient food and water.
• You must be fully capable of physical mobility and moderately physically fit to participate in these surveys.
• If children are present, they must be supervised by an adult.
• Avoid working under the tree canopy where you are at risk of falling branches and pine cones.
• Survey in groups of at least two people to maximise safety and improve the reliability of the survey results.
• If surveying a site close to a road, beware of traffic.
I HAVE READ AND ACKNOWLEDGE THE ABOVE HEALTH AND SAFETY INFORMATION.
SIGNATURE: DATE: / /
(if electronic submission, just type your name)
Please send completed forms to:
Hugh Finn
Great Cockatoo Count Coordinator, BirdLife Australia
Peregrine House, 167 Perry Lakes Drive, Floreat, WA 6014
E
T 9287 2251 or 0400 177 615
Last Updated: 21 Jan 2013 by Tamara Kabat