Emerald Ash Borer Reporting Form
Contact Information
First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Email
Your answer
Location of Sighting
Street Address
(If there is no street address, describe as best you can the location [a park, a business name, etc.]. Please use any landmarks you observed at the site to help indicate the exact location. Note street intersection if appropriate.)
Your answer
City/Town
Your answer
Zip Code
Your answer
Sighting Details
Describe the insect seen, if one was observed
(Color, size, shape, etc.)
Your answer
Describe any ash tree damage seen, if any [NOTE: Emerald ash borer only attacks ash trees, genus Fraxinus.]
(Holes in tree [indicate size and shape], S-shaped tunnels in bark, dieback of upper canopy of tree, etc.)
Your answer
Additional Questions
How did you hear about the emerald ash borer?
Anything Else?
(If you have any other questions or issues not addressed in this form, let us know here)
Your answer
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