BAN: Bluebird Report Form

Annual Bluebird Report Form - Bluebirds Across Nebraska (BAN) P.O. BOX 67157 Lincoln NE 68506-7157 Note: If you had boxes in more than one County, please submit a separate report for each County
*Last Name:	*First Name:		*County (you live in):	*Are You a BAN member? Yes No
*Address:	*City:		*State:	*Zip:
Telephone Email	*County (bluebird boxes located):		Would you like a BAN brochure? Yes No	*Year monitored::
Approximately how often did you check your trail? (i.e. once a week, every other week, every day, etc)
How many bluebird boxes did you monitor?				*
How many nesting attempts did bluebirds have? (count all attempts whether successful, abandoned, destroyed by predators ,etc)				*
How many successful broods of bluebirds? (a single nesting where one or more bluebirds fledged)
Total number of bluebird eggs?
Total number of bluebird eggs hatched?
Total number of bluebird fledged? (bluebirds that successfully left the nest) Note: Please indicate if the birds fledged were mountain bluebirds which are generally found in the western part of the Nebraska.				* Mountain Yes No
How many bluebird boxes did wrens:		Try to Use		Successfully use?
How many bluebird boxes did house sparrows:		Try to Use		Successfully use?
How many bluebird boxes did tree swallows:		Try to Use		Successfully use?
How many tree swallows successfully fledged from your bluebird boxes?
What other birds successfully used your bluebird boxes?
Please document any special comments, concerns, or problems here:
Please submit this form by October 15 You can also submit a printed form using the following link: PDF Format