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Significant tree nomination form
IMS – Tree (Significant) Nomination Form
Person nominating tree(s)
(This information will be kept confidential)
Name
*
First Name
Surname
Address
*
Address Line 1
Address Line 2
Suburb
State
Postcode
Phone
*
Email
*
Information about the tree or trees being nominated
Location description
*
(recognisable location)
Lot No.
*
House No:
*
Street Name
*
Suburb
*
Postcode
*
Number of trees?
*
(Please indicate if you are nominating a single tree or a group of trees)
Single tree
Group of trees
Common Tree Name(s)
*
Latin (Botanical) Name(s)
Height (metres)
Trunk Diameter (metres)
Estimated Age(s)
What makes the tree (or trees) significant?
*
(Please choose one or more category/s below)
Outstanding Visual/Aesthetic Significance
Botanic/Scientific Significance
Significant Ecological Value
Historical, Commemorative, Cultural and Social Significance
Other
Other significance
*
Name
This field is for validation purposes and should be left unchanged.
