DNR Fisheries Aquatic Education Partner Database — Data Entry Form 2014

DNR Fisheries Aquatic Education Partner Database — Data Entry Form
2014
Educational/Outreach Activity Name (one per entry page):
Age Appropriate for this Activity (please check all that apply):
⃝ Actual Age or Grade Target: ______ years and/or ________ grade
⃝ Adults
⃝ High School
⃝ Middle School / Jr. High
⃝ All Elementary ⃝ Families ⃝ Seniors ⃝ Educators and Teachers
Description:
Organization Name:
Address:
Phone:
Select Category and Sub-Category (please check most appropriate descriptions,
select only one main category and then as many sub-categories that apply):
⃝ Fishing Instruction
⃝ Fly Fishing
⃝ Ice Fishing
⃝ Hook-n-Line/Bait Fishing
⃝ Fishing Regulations and Ethics
⃝ Environmental Stewardship
⃝ Rivers and Streams
⃝ Lakes
⃝ Watersheds
⃝ Best Management Practices
Please describe: _________________________________________________
_______________________________________________________________
_______________________________________________________________
Website:
County:
Check box if you need volunteers!
Location or Facility of Educational Opportunity (if applicable, please include
name of facility and location, address, city, and county IF different from above):
⃝ Water Quality
⃝ Water Sampling (pH, turbidity, dissolved oxygen, temperature, etc.)
⃝ Macroinvertebrates (sampling aquatic insects and identification)
⃝ Nonpoint source pollution, Stormwater ⃝ Point source pollution
⃝ Vegetation Buffers, Rain Gardens, Filter Strips, etc.
Month (if offered at the same time each year, otherwise it may be offered year
round, or upon demand, always 2nd week of May, etc.—please describe):
⃝ Community Service Learning Project
⃝ Opportunities for Adults
⃝ Opportunities for Youth
⃝ Opportunities for Families—adults and youth
Contact Info: Your name and phone number in case we have questions!
⃝ Specialized Events
⃝ Free fishing event, derby, etc.
⃝ Celebration/Festival—station, booth, etc.
Please return to: Suzanne Ebright, DNR-Fisheries, P.O. Box 30446, Lansing, MI 48909
FAX to (517) 373-0381; email to [email protected]; phone (517) 284-6162