Reservation Form -Winter Sampling

Your Name(Required)

First Last

Your Email(Required)

Your Phone #(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone #(Required)

Position/Level of education(Required)

Affiliation(Required)

Department if Affiliation is 'UW Madison Other' selected above(Required)

Arrival Date:(Required)

Estimated Arrival Time:(Required)

Morning

Afternoon

Evening

Departure Date(Required)

Estimated Departure Time:(Required)

Morning

Afternoon

Evening

Winter sampling: Acknowledge the following cautions(Required)

Never drive a truck on a snowmobile trail.

Pump water samples only if temperature >10 F (possibly colder if heated tent available).

Always have one person outside of the vehicle when driver is backing up trailer.

Never leave a snowmobile trailer or truck on the side of a road.

Wear a survival suit, or an equivalent safety and flotation device.

Contact TLS personnel to get update on lake conditions (ice depth, snow depth and slush conditions)

Always have a sampling partner when doing winter sampling

Be sure to sign out on the board in the TLS office

You will hear from someone from TLS confirming your plans

Will you need housing?(Required)

Yes

No

How many will need housing?(Required)

Housing units will be allocated by TLS and the group leader will be responsible for assigning individuals to rooms.

Are there any animal allergies we need to be aware of?(Required)

Yes

No

Specifically, what animal allergies are a concern for housing?(Required)

Is there anything else not addressed above that you want us to know? Please let us know if you had any problems with this Reservation Form.

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