Sanctuary Application
Completed application form must be sent with payment.  Please fill in all fields below that apply.  
Sign in to Google to save your progress. Learn more
Name of Property *
City, State, Zip Code *
County *
Acreage *
Approximate Number of Acres
INFORMATION ABOUT PROPERTY
Approximately what percentage of the property is comprised of the listed type of land.
Farm
Field
Pasture
Woods
Name of Owner *
Street, RD or Box # *
City, State, Zip *
E-mail Address or Phone # *
Type your name and the date below to indicate your understanding of and agreement with the following statement:
I DECLARE MY INTENTIONS OF DOING MY BEST TO SEE THAT THE PROPERTY IS TREATED
AS A WILDLIFE SANCTUARY AS LONG AS THE BBC SIGNS ARE USED TO POST IT.

I understand and agree that the use of these sigs does not give the Brooks Bird Club, Inc. (BBC) any rights whatsoever over the lands on which the signs are erected, nor does it in any way place any liability upon the BBC with respect to the use of such lands.

Electronic Signature
Full Name *
Indicate the number of sanctuary signs you desire. *
Signs are $10.00 (price includes shipping). WV residents must additionally pay $0.60 tax per sign.
Method of Payment *
* Checks are made payable to: Brooks Bird Club Inc. Mail to: BBC Sanctuary Signs, 4326 Chelsea Harbor Dr W, Jacksonville, FL 32224.
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This content is neither created nor endorsed by Google.