Name of Applicant:_____________________________________

Organization:__________________________________________

Address:


Office Telephone:
Home Telephone:
E Mail and/or FAX:
Emergency Contact:

Project Title:

Project Description (attach additional pages if necessary):






Anticipated Project Start Date:
Anticipated Project End Date:

The applicant agrees to the following conditions:
1. A brief summary of activities and findings that are pertinent to Zilker Botanical Garden (including a list of identified insect taxa, name of identifier, and place of specimen deposit for entomological projects) will be sent to the current Biologist, Zilker Botanical Garden at 2220 Barton Springs Rd., Austin, Texas 78746 each year by Dec. 31, or earlier upon request.
2. No collecting or site disturbance except as described above.
3. A Zilker Botanical Garden issued research permit badge is to be worn at all times while working on the grounds of the Garden and to be turned in following completion of the project.
4. The City of Austin reserves the right to cancel this agreement without prior notice.
5. I understand renewal of the permit will be based on compliance with the above.

Applicant's Signature _______________________________________ Date ________

Approved by : _____________________________________________ Date ________
Biologist, Zilker Botanical Garden, Parks and Recreation Department