First Name *
Last Name *
Email Address *
Are you applying as an individual or as an organisation/business? *
Individual
Organisation
Do you agree to install the drinker(s) within 6 weeks of delivery and provide ongoing monitoring and maintenance (e.g. refill and clean)? *
Yes
No
You will be required to sign an ‘installation, maintenance and monitoring agreement’ if allocated drinkers. Please confirm you have read the agreement and agree to sign this if your application is successful? *
Yes
No
Are you applying to receive drinkers for installation on private or public land?
*
Private
Public
Both
What is the primary use of the property? *
Are you the owner of the property? *
Yes
No
How long have you lived there, or had authority over the property? *
What is the size of the property/location? *
-- Please select --
hectares
m2
Is the property located in a fire or drought affected area? *
Yes
No
Was the property/location(s) impacted by the recent Black Summer fires and drought?
*
Yes
No
Do you regularly see native wildlife on the property? *
Yes
No
What wildlife did you see or know were on the property pre drought/fires (if applicable)?
What % of the land was covered by native vegetation/wildlife habitat pre drought/fires (if applicable)?
What % of the land is covered by native vegetation/wildlife habitat now? *
Is the native vegetation on your property made up of large connected areas? *
Yes
No
Is the property contiguous to a National Park, Natural Reserve or other protected natural areas?
*
Yes
No
Are there any wildlife drinking stations on the property now? *
Yes
No
Are there any permanent (i.e. with water all year around) water points that wildlife might access on the property (e.g. dams, livestock water troughs, lakes, rivers)?
*
Yes
No
If there are permanent water sources, are there areas of native vegetation 500 metres away from these that are appropriate for a drinking station? *
Yes
No
Are there ephemeral (i.e. not permanent - they might dry during the year) water points on the property (e.g. dams, creeks)?
*
Yes
No
Drinkers must be at least 500 metres away from any other drinkers and permanent water sources - how many drinkers do you estimate are needed? *
Please describe where you would like to see them installed and why *
Please refer to 'commitment declaration' to see what is involved/expected and confirm how many drinkers would you be able to install within 6 weeks and maintain and monitor on an ongoing basis? *
Who would be responsible for installing the drinker(s) *
Who would be responsible for ongoing maintenance of the drinker(s) : *
We are planning to add cameras to a number of drinkers but do not yet have the funding to add them to all drinkers, would you be interested in receiving a camera and being involved in ongoing monitoring of the footage?
*
Yes
No
If we cannot provide a camera would you consider purchasing them to be involved in the ongoing monitoring program (e.g. ScoutGuard infrared heat-in-motion sensing cameras model SG560K approximately $400 plus delivery)? *
Yes
No
Who would be responsible for the ongoing camera monitoring, sharing the footage with us? *
Would WIRES and/or key drinker project partners be able to access the drinker(s) to check the installation?
*
Yes
No
With your permission would WIRES and/or key drinker project partners be able to visit the site to film the drinker and/or organise media to attend to share the details and success of the program?
*
Yes
No
Any additional information you would like to share to support your application *
Prove you're not a robot *