TELL US ABOUT THE LAND YOU WANNA KEEP WILD

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* 1. What is the location of the wild patch?
(the address or a description so that we can plot it on our map)

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* 2. What resources shall we send you?

Street chalk

Bamboo #WeWantThisWild sign

Printed petitions

Wildlife survey record sheets

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* 3. Where should we send your resources?

Name

Address

Address 2

City/Town

Postal Code

Country

Email Address

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* 4. Do you have any community support for keeping this spot wild?
(it's okay if you don't have any support yet... we'll work on this together)

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* 5. Do you know who owns the land?
(it's okay if you don't know yet... we'll work on this together)

No

Yes

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* 6. We’d love to see the wild patch and the wildlife it’s attracting.
Upload any photos we can post on our map and use to for the campaign.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.