Enter General Site Info
Please do not use all capital letters
Name of Site/Public Land Area*:
Agency*:
Contact Name*:
Enter Site Address Info
Site Address*(no P.O. boxes please):
Address 2:
City*:
State*:
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
Saipan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Islands
Guam
Zip Code*:
Is the mailing address the same as the site address?
Yes
No
Enter Your Mailing Address
Mailing Address (no P.O. boxes please):
Mailing Address 2:
Mailing City:
Mailing State:
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Islands
Guam
Mailing Zip Code:
Enter Contact Info
NOTE: contact information and site address information will be posted on our website. Do
not share any personal information in these categories that you do not want to be made public.
Contact Email*:
Phone Number*:
Website*:
Other Info
What is the closest metropolitan area?
Approximately how far?
Estimated number of volunteers:
How many brochures would you like? (packed in 25's)
How many promotional posters would you like?
In addition to National Public Lands Day being a fee free day in many federally managed lands, volunteers who participate in NPLD at federal
land sites are rewarded with coupons for fee free entry into their favorite public land areas that have entrance fees. Site managers from the Bureau of Land
Management, National Park Service, U.S. Army Corps of Engineers, U.S. Fish and Wildlife Service, and USDA Forest Service may request fee free coupons for their
volunteers. If you are an eligible site manager from one of the federal land management agencies listed above, how many fee free coupons
would you like?
Are you registering multiple sites? A "site" is a volunteer work event at a single park or public land
area . If so, how many sites? Will there be more than one work project at your site(s)- examples: trash pickup, tree planting, weed pulling? A "project" is a specific volunteer work activity
at a site with an independent crew leader. If so, how many total work projects?
Work projects planned for volunteers (Details will make website listing more useful):
Will your event be held on a date other than September 25, 2010?
If so, which date will it start on?(mm/dd/yyyy)
And which date will it end on?(mm/dd/yyyy)
The free water kit offer from World Water Monitoring Day is no longer available. If you would like to purchase a kit, please go to, http://www.worldwatermonitoringday.org/Test_Kits/Order_Kits.html . The kits, a part of the free offer, will be mailed in August. Our non-profit partner KaBOOM! is offering NPLD sites the chance to win a $10,000 grant to events that incorporate improvement projects and use the Play Day website. Join the KaBOOM! Play Day program to be part of a national celebration to save play in the lives of children.
Check this box if you do not want to automatically register your NPLD event as a KaBOOM! Play Day and receive a link to a personalized KaBOOM! planning website which will help you invite people to your event, and includes free game and activity ideas.
Manager Name:
