Wisconsin and Ozaukee Humane Societies: Survey - Bird Safe Home Participant Registration

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Bird Safe Home Participant Registration

Registration Information:

Name:

First Required	Last Required

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

City Required	State Required	ZIP Required

Yes, I would like to receive e-mail from Wisconsin and Ozaukee Humane Societies

Yes, I would like to receive postal mail from Wisconsin and Ozaukee Humane Societies

Remember me.

Question - Not Required - Bird Safe Home address, if different than above:

Question - Required - What steps are you taking to protect wild birds from collisions with your home's windows? Check all that apply:

	Use awnings over some windows to reduce reflections on exterior glass.
	Apply window decals or clings. Use fluttering strips, CDs strung together or other moving devices on windows.
	Apply CollidEscape or other anti-reflective window film.
	Use BirdScreens or other mesh over problem windows.
	Close draperies or blinds on corner or other "see through the house" windows.
	Place bird feeders less than 3 feet or more than 30 feet from windows.
	Incorporate bird-safe design features (small windows, downward-angled glass, fritted or etched glass, etc.).

Question - Not Required - Is there anything else you are doing to reduce window collisions? If so, provide details:

Question - Not Required - Additionally, for high-rise apartments or condos:

Minimize or preferably extinguish night lighting (lighting visible through exterior windows and exterior lighting), between the hours of 11 p.m. and 7 a.m. during migration periods (mid-August through October and mid-March through May).

Question - Not Required - In addition to preventing bird window collisions by taking the steps above, what else are you doing to help birds? Check all that apply:

	Keep my bird feeders and bird baths clean; feed clean, dry seed and fresh birdbath water.
	Minimize or eliminate the use of chemical pesticides and fertilizers on my property.
	Incorporate native plant species on all or a portion of my property to provide food and cover for birds.
	Keep my cats indoors or have them under my control and supervision while they are outdoors to keep them from becoming lost, to protect their health and safety and to minimize the risk of them injuring or being injured by wildlife.
	Any bird houses I provide are selected and maintained to minimize their use or disruption by non-native bird species.
	Help control West Nile Virus on my property by eliminating standing water that mosquitoes use to breed.

Question - Required - Include my name on the list of Bird Safe Home participants on the Wisconsin Humane Society's WIngs Bird Safe Home Particpant web page.

You may provide up to five digital photos (less than 250KB each) of your home’s bird-collision prevention features. Submission of these photos includes permission for the Wisconsin Humane Society to use these images, if we so choose, in our portfolio of bird window-collision prevention techniques. Send your images as an e-mail attachment to wings@wihumane.org.