Berkshire Keeping Track® Monitoring Program Training
Application Form
(You can download a form (.doc), or make your own. Please include the information below.)
Date:_____________________
Name:_________________________________________________________________________
Mailing Address:__________________________________________________________________
Town/State/Zip:__________________________________________________________________
Physical Address:_________________________________________________________________
Telephone(s): ______________________ email _______________________________________
I am interested in encouraging, supporting or being involved in the creation and ongoing success of the Berkshire Keeping Track Monitoring Program.
Please check all items that apply to your interest and circumstances, and return this form to Joan Cousins, 1480 West St., Pittsfield, MA 01201 413-443-1154 jcousins@berkshire.rr.com
_______ I am ready to commit to being a member of a local KTMP team.
_____ I realize this commitment requires 6 day-long training sessions and transect monitoring with a team once each season [4 times a year] on an ongoing basis.
_____ Enclosed is a check for $25. payable to BEAT (Berkshire Environmental Action Team, Inc.) to reserve one of the training slots for me. [This will be applied to the fee.]
_____ I am interested and would like to be contacted to further discuss my potential involvement.
_____ I cannot commit to the training and annual monitoring; however, I would like to support the effort. I will:
_____ assist a participant with funding support.
_____ make a general contribution to support the project.
_____ help with the promotion and clerical aspects of the project.
_____ other: [Please give us the benefit of your ideas and suggestions]
I suggest you contact ______________________________, another potentially interested person.
Questions/Suggestions/Ideas/Words of Encouragement...
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