NCBC RARE BIRD DOCUMENTATION FORM

Submitted as documentation of (check all that apply):
___Unusual species ___Unusual date ___Unusual habitat

1. Count Name: _______________________________Count Code:_____________________

2. Species______________________________________Age______Sex_____#____________

3. Date (s) of Observation_______________Time_______to______________________________
Earlier/Later dates by others, if known________________________________________________

4. Place_______________________________________________________________________
Nearest town __________County_________________________________________________

5. Observer____________________________________________________________________
Address_______________________________________________________________________
Telephone/fax/e-mail____________________________________________________________

6. Observation Details:
Other Observers________________________________________________________________
Optics used___________________________________________________________________
Distance from bird___________________ Viewing conditions__________________________
Weather, sky cover_____________________________________________________________
Photo taken?____ Video?____ Sound recording?_____ Specimen?_____________________
Are these available to the CBC Regional Editor? ________ Where are they?____________

7. Past Experience: With this or similar species? ____________________________________

8. References or advice consulted: ________________________________________________

9. Was this report done from notes made during or after observation or from memory? _______

10. Notes: On back of form give complete details of this observation. Use additional sheets as needed. Include information on the bird's plumage, shape, size, vocalizations, habitat, behavior, etc. Describe exactly what you saw; include photocopies of your original notes and sketches. Name the species that you considered ID contenders; explain how you eliminated them.

Signature____________________________________Date______________________________

Please send this form directly to Regional Editor
(For addresses visit: www.audubon.org/bird/cbc/regional/regional_ed.html) or see the
Regional Summaries in the 106h CBC issue of American Birds
Please send in your CBC photos! • Any questions email us: cbcadmin@audubon.org