Data-Entry Form for Boater Surveys
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About the Interview:
Interviewer:

Date:

 Time: AM

PM

Waterbody: State:
Launch Site : Type:
About the Boat:
Transport : If "other" explain:
Home State: How many times has your boat been launched in the last year?
Zip Code:

Is it always launched in the same waterbody?

 Yes No
  Boat Type: If "other," what kind?
Where has the boat been?
Water Body 1: State: County: Date:
Water Body 2: State: County: Date:
Water Body 3: State: County: Date:
Where will the boat launch next?
Water Body 1: State: County: Date:
Water Body 1: State: County: Date:
Water Body 1: State: County: Date:
Does boater clean boat & trailer between launchings? Yes No
Is the boat primarily kept on land or in water when not in use? Land Water
  If in water, where is it kept? Waterbody: State:
Information Exchange: Boater asked questions:
 

Boater was already aware of threats of ...

Zebra Mussels
any other Aquatic Nuisance Species
 
Results of Boat Inspection:
  Inspection by:
    Type of ANS found: Location of ANS:
  Describe ANS if "other" Action Taken:
Comments:
This record is...
Genuine (real data)
Bogus (just testing)