SEED CERTIFICATION AGENCY (SCA)

Certified Seed PRE-COLLECTION APPLICATION for Wildland Collected Seed

Application/Certification # Application Fee⁶

Assigned by SCA

Applicant¹ Phone Fax _________________

Address Cell E-mail _______________

Species Name Common Name ____________________________

Site Ownership: Public __________________________________________________________________________

Agency name and office to issue permit/contract/permission

Private _____________________________________________________________________________________

Landowner or agent name(s)

Site Location² State County Elevation ______________________

Latitude GPS³ __________________________________________________________

Site Size/Description⁴

Material to be Collected⁵ Collection Dates⁶ Start End _________

Collection Personnel⁷

Name of Crew Leader

Address

Phone/Cell

¹ Applicant may be the collector, seedbroker/conditioner, or other party. Membership in SCA may be is included with this application. Information on this form is confidential and is for SCA use only.

² In general, complete a separate application for each specific species (or recognized subspecies) site location. For species that occur in harvestable stands over broad non-contiguous areas, an application must be filed for at least each species/county area.

³ GPS coordinates preferred if exact site of stand known before harvest.

⁴ List approximate number of acres or square miles if stand is mostly contiguous, or describe (or outline on topographic map) geographic area within county to be collected from (e.g. stream drainage, specific valley, mountain range, etc.). List MLRA zone, or other defined ecological area as applicable.

⁵ For example, seed, seed stalks or heads, cuttings or other vegetative part, cones, fruit, etc.

⁶ Application must be completed and FAXed to SCA Representative (xxx-xxx-xxxx) and then immediately mailed with application fee to SCA address preferably one month or more but at least one day before harvest (exceptions on a case by case basis and with time and mileage fees assessed). This initiates the wildland collected seed certification process and contact with collector groups. The SCA will then verify collection site harvest by spot checks before, during, or post harvest utilizing detailed maps, GPS coordinates, and/or accompaniment with collector(s) to the site.

⁷ List known collector groups that will be harvesting for you on this site (list additional groups and information on back of white copy and include in FAX). Maps, GPS readings, and other exact site location information relative to an individual collector are regarded as confidential.

I hereby apply for certification of wildland collected plant material from the above described site. I agree to abide by all of the rules and regulations governing certification according to the above named certification agency under the auspices of AOSCA, the Association of Official Seed Certifying Agencies.

Applicant __________________________________________ Date _______________________________

FAX to (xxx)xxx-xxxx, then mail original with fee to SCA

PHOTOCOPY for Applicant Records

6/18/02