FCBS Online Seed Collection Form

1: Collector Name:*
e.g. Ann B. Smith
2: Collector Email Address:*
3: Collector Telephone:*
4: Collector Fax number:
5: Permit number or relationship to landowner:*
DOACS Regulated Plant Index Harvesting Permit (DACS-08135)
Permit # is typed in upper right hand corner of permit.
If you are not required to have a permit, give your position (e.g., park biologist).
6: Species Collected:*
select from dropdown list
e.g.Tillandsia fasciculata
7: Variety (if appropriate):
8: Local Bromeliad Society:
e.g. Bromeliad Society of Central Florida
9: Date of Collection:*
(give it in military style:
day - first 3 letters of month - year in full)
- e.g., 4-JUL-2001
10: County of Collection: *
11: Locality:*
e.g. 2.4 mi S of Palmdale on Hwy 29
12: Habitat:*
e.g. from one of a group of cypress trees
13: Latitude:*
e.g. 2653.59'N
14: Longitude:*
e.g. 8123.49'W
15: Photos:* I will email digital photo(s) to
I will mail in my photo(s) for scanning
Sorry, I have no photo(s)
16: Name of person in charge of germination/growth:*
17: Address of place where seed is being germinated/grown:*
18: Comments:
*Required fields


Please insure that you have filled in all the required* information before pressing the submit button.
Your form will be emailed to the Database Coordinator, Carolyn Schoenau