Scientific Collection Permit Threatened and Endangered Species Permit Salvage Permit General Information Change the Zoom (+ or -) setting of your browser to better fit the form to your computer screen. Collection Permit Information Permit #: Affiliate Category: Associations or Professional Societies College or University Consultant or Researcher County, City or Local Government Federal Agency K-12 School Non-Profit Organizations Other Professional Zoological Collection State Agency Collection Category: Agency Species Management Biomonitoring Contract Environmental Impact Contract Species Specific Survey Educational/Instructional Other Research Volunteer Species Survey Permit Type: Collection Salvage T&E Taxa Group: Select the Taxa Group of your Target Species. If there is no Target Species, select 'Not Applicable' Amphibians Aquatic Crustaceans Aquatic Insects Aquatic Molluscs Birds Fish Macroinvertebrate Water Quality Sample (No ID for genus/species) Mammals Marine Mammals Other Other Aquatic Invertebrates (Not Water Quality Sample) Other Terrestrial Invertebrates Reptiles Terrestrial Insects Target Species: Species names are listed as 'common name - scientific name,' with the base of the common name listed first (e.g., 'Eagle, bald - Haliaeetus leucocephalus'). Search the dropdown box by starting to type the common name of the species. A generic common name followed by the scientific name is available for species with no common name (e.g., 'Millipede - Pseudotremia sublevis'). Multiple target species can be selected by holding the Ctrl key. Coordinate/Geographic Information Lat/Long (Degrees Minutes Seconds)Lat/Long (Decimal Degrees)Lat/Long (Degrees Decimal Minutes)UTM Datum/Spheroid NAD83/WGS84NAD27/Clarke 1866 Principal Permittee Information First Name: Last Name: Affiliation: Phone Number(0-9 Only): Email Address: Data Entered By Same as Permittee First Name: Last Name: Affiliation: Phone Number(0-9 Only): Email Address: Collection Site Information Field Collectors Names First Name: Last Name: Select the 'Add Collector' button to add the entered collector name to the form. For multiple collectors, enter the next name and select 'Add Collector' Collection Site and Methods Your Site ID (optional): Site Description: Waterbody (Nearest Waterbody): County: Accomack Albemarle Alexandria Alleghany Amelia Amherst Appomattox Arlington Augusta Bath Bedford Bedford City Bland Botetourt Bristol Brunswick Buchanan Buckingham Buena Vista Campbell Caroline Carroll Charles City Charlotte Charlottesville Chesapeake Chesterfield City of Franklin Clarke Colonial Heights Covington Craig Culpeper Cumberland Danville Dickenson Dinwiddie Emporia Essex Fairfax Fairfax City Falls Church Fauquier Floyd Fluvanna Franklin Frederick Fredericksburg Galax Giles Gloucester Goochland Grayson Greene Greensville Halifax Hampton Hanover Harrisonburg Henrico Henry Highland Hopewell Isle of Wight James City King and Queen King George King William Lancaster Lee Lexington Loudoun Louisa Lunenburg Lynchburg Madison Manassas Manassas Park Martinsville Mathews Mecklenburg Middlesex Montgomery Nelson New Kent Newport News Norfolk Northampton Northumberland Norton Nottoway Orange Page Patrick Petersburg Pittsylvania Poquoson Portsmouth Powhatan Prince Edward Prince George Prince William Pulaski Radford Rappahannock Richmond Richmond City Roanoke Roanoke City Rockbridge Rockingham Russell Salem Scott Shenandoah Smyth Southampton Spotsylvania Stafford Staunton Suffolk Surry Sussex Tazewell Virginia Beach Warren Washington Waynesboro Westmoreland Williamsburg Winchester Wise Wythe York Collection Date (mm/dd/yyyy): Collection Method(s) and Effort(s) Collection Method: Aquatic Collection by Hand Aquatic Dip net Aquatic Electrofishing Aquatic Gill nets or Trawl nets Aquatic Kick samples Aquatic Nets-trap (Fyke / Hoop / D-frame / etc.) Aquatic Other Aquatic Rod and Reel Aquatic Scuba Aquatic Seine nets Aquatic Snorkel Aquatic Substrate grab sampler (vacuums / dredge / etc.) Aquatic Traps (Minnow / Pot / Bell / etc.) Aquatic Viewscope Terrestrial Audio (anurans / birds) Terrestrial Cannon nets (launched nets) Terrestrial Collection by hand Terrestrial Foot-hold traps (snares / jawed / tangle) Terrestrial Hand nets (butterfly / reptile / etc.) Terrestrial Live-traps (Box / Pitfall / Funnel / Bell / Pot) Terrestrial Lures (baits / light / cover boards / etc.) Terrestrial Mist nets (bats / birds) Terrestrial Observation Terrestrial Other Collection Effort: < 1 hour 1 hour 2 hours 3 hours 4 hours 5 hours 6 hours 7 hours 8 hours 9 hours 10 hours 11 hours 12-14 hours 14-16 hours 16-18 hours 18-20 hours 20-22 hours 22-24 hours 24-36 hours 36-48 hours 48-60 hours 60-72 hours 72-84 hours > 84 hours Select the 'Add Method/Effort' button to add the selected method and effort. When multiple collectors use the same gear (i.e., dip net), effort is the number of hours multiplied by the number of collectors (e.g., 2 collectors survey for 3 hours = 6 hours total effort). Geographic Coordinates Degrees Minutes Seconds Latitude: Longitude (-): Detail Species Information Species Information Data for species records are submitted one at a time instead of all at once. Submit each species record individually by date and site. You will have the option to retain collection information between species submissions. View and export your records by selecting 'Search For Permit Record(s)' at the bottom of the form. If you notice any errors in your submission, email corrections to CollectionPermits@dwr.virginia.gov. Taxa Group: Select the Taxa Group of the Species to be entered. If Target Species was not observed, make an entry with Quantity = 0. Amphibians Aquatic Crustaceans Aquatic Insects Aquatic Molluscs Birds Fish Macroinvertebrate Water Quality Sample (No ID for genus/species) Mammals Marine Mammals Other Other Aquatic Invertebrates (Not Water Quality Sample) Other Terrestrial Invertebrates Reptiles Terrestrial Insects Species: Quantity: Condition When Collected/Observed: Dead Fresh Dead Live None Shell, Relic Final Disposition: Applied Tag/Mark and Released None Observed Released Dead Released Live Retained Dead Retained Live Other Information Field Tag Number(s) and Color(s) Observed or Captured Tagged Individuals OR Tags/Marks you applied. (Excludes ALL Color Coded Bird Bands. All tag numbers for the same species should be included in the Field Tag Number box and separated by semi-colons(;)) Overall Comments: This form is required for all issued permits, in accordance with the permit agreement and VA wildlife regulations (examples: Collections, Surveys, Studies, Relocations and other related activities). A completed form for all taxa groups and all collections is required by January 31 for the previous years' collections. Email Collection Permits