6. Name of person filling out this form:

7. Email of person filling out this form:

8. Brief description of the project/course:

9. What part of the property do you wish to use? What access/egress will be needed?

10. How will your project be funded?

11. What percentage of the necessary funding for your project is assured?

12. Will your project have any potential impacts on nearby habitats, facilities, or projects? Yes No

If yes, please describe:

13. Will you require support from Landscape Services i.e. mowing a path or clearing some underbrush? Yes No

If yes, please describe:

14. Will you need to bring motorized vehicles onto the property? Yes No

If no, go to question 17.

15. List motor vehicle

16. Will these vehicles be going off of existing roads/paths? Yes No

17. How many people will be entering the property at once?

18. Will they be dispersing from the trails? Yes No

19. Will you need to bring any mobile power source onto the property? Yes No

If yes, describe the power source(s), their noise levels, and when, where and how long they will be used:

20. Will you need to bring any chemicals, solvents, or toxic materials onto the property? Yes No

If yes, please describe:

21. Will they be collecting specimens or taking samples? Yes No

If no, go to question 26.

22. What is the nature of the collection or sampling?

23. Will the collecting or sampling leave a visible sign? Yes No

24. Have you defined the minimum and maximum number of samples necessary?
Yes No

If yes, please describe:

25. If it is feasible to return specimens/samples will you do so?
Yes No Not Feasible

26. Does your project necessitate a change or disturbance of the landscape, the construction of any structures, or the installation of posts, well heads or pipes, fences, plastic covers or barriers, or markers? Yes No

If no, go to question 33.

27. What is the size or area and the visibility of the change, disturbance, structure, or other objects?

28. Is the change, disturbance, structure, or object, relatively permanent? (lasting 5 or more years) Yes No

If yes, go to question 33.

29. If the change is temporary, will it be removed, decompose, or regrow? Yes No

If yes, please describe how and by when?

30. Will there be a cost for the removal of the structure or object and/or restoration of the site? Yes No

31. Is that cost included in your proposal? Yes No

32. Please describe how your research or educational activities help maintain and/or support the enhancement of the preserve:

For any questions please email Cari DeLong at cari.delong@wmich.edu

A confirmation email will be sent to you when the application is received.