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* 1. Contact Information

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* 2. Do you grant permission for GEI or its project partners to conduct a visualĀ 
survey for Hemlock Woolly Adelgid (HWA) on your property (please note that this comes at no cost to you and does not obligate you for any future action, nor does it allow any other entity to enter your property or contact you in a way)?

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* 3. If HWA is found on your property, are you willing to consider chemical treatment at no cost to you through a federal Great Lakes Restoration Initiative grant (more information will be provided at a later date)?

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* 4. Would you like someone to contact you to learn more about HWA?

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* 5. Do you have any comments or questions?

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* 6. I verify that I have the authority to allow visual surveys for HWA on the address provided.

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