Record Sheet/Submittal Form

All trees planted in Clark, Crawford, Floyd, Harrison, Jefferson, and Ripley, Scott Counties between August 22, 2007, and August 22, 2012, and submitted on this form will count towards the Plant A Tree For You And Me goal of 100,000 trees. Fill out this form and click the "submit" button below to make your trees count!

This form may also be printed and mailed to the SWCD servicing your county. Addresses are given at the bottom of this page.

Please note: The information below is for internal use only for tracking numbers of trees and will not be shared, distributed, or sold.

Name:
County:
Address:

Complete Address of Tree Planting (if not at the address above):

Phone: Email:
Date(s) of planting: Place of purchase:
Species planted and number of each - include woody shrubs as well as trees. Use either the common or Latin name found on plant label.
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Species: # Planted:
Type of tree(s) planted:
Bare root trees ( a seedling grown in a nursery bed that has the soil removed from the roots before packaging and shipping - the tree may look like a small branch with roots)
Balled and burlapped trees (a method of transporting larger trees with most of the root system enclosed in a ball of aoil, wrapped in burlap or similar material).
Container trees (a tree that is grown in a bucket-like container at the nursery and sold in the container).
Purpose of Planting (check all that apply):
Landscaping/beautification/shade Riparian area buffer
New subdivision/devlopment Erosion control
Conservation buffer Reforestation
Noise filter Outdoor lab/education
Windbreak Wildlife
Tree industry/Production Other

All programs and services are offered on a non-discriminatory basis, without regard to race, color, national origin, religion, sex, age, marital status or handicap.

Please submit mail-in forms to your home county. Thank you!

Clark County SWCD
9608 Highway 62
Charlestown, IN 47111
812-256-2330, ext. 3
www.clarkswcd.org

Crawford County SWCD
306 Oak Hill Circle
English, IN 47118
812-338-3224, ext. 258

Floyd County SWCD
311 West 1st St., Room 421
New Albany, IN 47150
812-945-9936
www.floydswcd.org

Harrison County SWCD
1855 Garner Lane, N.W.
Corydon, IN 47112
812-738-8121, ext. 3

Jefferson County SWCD
3382 W. SR 56, Suite 2
Hanover, IN 47243
812-273-2070, ext. 3

Ripley County SWCD
1981 S. Industrial Park Rd., Suite 2
Versailles, IN 47042
812-689-6410, ext. 3

Scott County SWCD
656 Boatman Rd.
Scottsburg, IN 47170
812-752-2269, ext. 3
www.scottcountyswcd.org