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SI Birding Blitz Application
Southernmost Illinois Birding Blitz
Registration Form
April 27, 2002
Please return the completed registration form by March 15, 2002 to:
Cypress Creek National Wildlife Refuge
0137 Rustic Campus Rd., Ullin, IL 62992
Team Categories Please Check One:
Open (teams not registering in a specialty category)
Musclepowered (no motorized transportation)
Senior (55 older)
Collegiate (college enrolled)
Youth (18 younger)
Registration Fees:
Number of Nonstudents x $20 = $
Number of Students x $10 = $
Total Fee enclosed: $
The Registration Fee should be made payable to Southern Illinois Audubon and sent with this form.
Put "Bird Blitz" in check memo area.
Name and address of Team Captain (Recorder)
Name:
Address:
Phone:
Names of Additional Team Members:
Name of your Birding Team:
Designated Environmental Group (optional):