Certification Form Please enable JavaScript in your browser to complete this form.Your Name *FirstLastEmail *Your Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs the habitat address the same as the above? *YesNoHabitat Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeType of Habitat Location *HomeSchoolBusinessOtherIf Other, please describe *Habitat ChecklistDoes your habitat Welcome Wildlife?LayoutClick all that apply (minimum 3): *Water FeatureNesting BoxesNative PlantsPollinator GardenBird Feeder(s)Upload photo of one feature (jpg or png) Click or drag a file to this area to upload. Does your habitat Create a Climate for Resilience?LayoutClick all that apply (minimum 2): *30+ feet canopy3-5 different levels of vegetationFew or no exotic plantsUpload photo of one feature (jpg or png) (copy) Click or drag a file to this area to upload. Will you act as an Environmental Steward?LayoutClick all that apply (minimum 3): *Install a rain barrelNix pesticidesRestore soilReduce or eliminate outdoor lightingCertification Package Note that it will take 4-6 weeks to print and deliver your garden signCertification Package *Certification + Garden Sign – $25.00Please consider a donation$5.00$10.00$20.00PaymentTotal$0.00Stripe Credit Card *Submit
