FHL Organism Collection Form
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Affiliation *
Name
Email Address
Research Purpose
Brief description of research.
Course Number *
Select "Independent Research" if the collection is not related to a UW course.
First Date of Collection *
MM
/
DD
/
YYYY
Last Date of Collection
.If there was only one collection date, leave this blank
MM
/
DD
/
YYYY
Location *
Choose the area closest to your collection site.
Numbers on this map correspond to those int he drop-down list above.
Other Location (optional)
Enter location if not included in the drop-down above.
Organism *
Species (if known)
Enter species.  If "Other" was selected as the organism, please list the species and/or a brief description.
Number Collected *
Submit
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