Application for South East LCH Program Please Note: To successfully complete this application you will need to download and complete the Native Plant Checklist here. You should also have photos of your property ready to upload. LCH Program Application - North Region Step 1 of 4 25% Your Name(Required) First Last Applying on behalf of (optional) Email(Required) Phone(Required)Habitat Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Certified Habitat Map Agreement(Required) I'm ok with my habitat + address being shown on a map. I'm ok with the general location of my habitat being shown on a map. Please don't include my habitat on any maps. Habitat Images Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 25 MB. Is it ok for us to use images of your habitat?(Required) Yes No What year did you begin work on your habitat? How would you describe your surroundings? Rural Suburbs Urban How big is your habitat site? (Approximate lot size or acreage) *(Required) Don't forget your unit of measurement!If your habitat has been certified by another organization, list it here. Name of organization and certification.Tell us about your site! My habitat provides(Required) Food (nectar, fruit, seeds, leaves) Water (mister, birdbath, naturally wet areas) Shelter (unmown areas, fallen branches, shrubs/trees) Check all that apply. You need 2 out of 3 for certification.I rarely use herbicides and insecticides except to spot manage invasive plants or destructive insects. I do not use mosquito repellant systems and nor do I use weed killer liberally in ditches and edging, as these chemicals harm other insects and helpful plants and end up in our watershed.(Required) Agree Disagree To increase habitat area, I only mow limited areas of my property. I use best practices to protect pollinators like keeping my mower blade set high (about 4 inches) and I leave dried grass and leaves in place through winter where possible.(Required) Agree Disagree I rarely leave soil bare and vulnerable to erosion and weeds. Instead, I use native plants as ground cover or I mulch with leaves or responsibly sourced material such as pine bark or pine straw NOT purchased, unsustainably harvested cypress mulch.(Required) Agree Disagree Does your site contain any rare plant or animal species?(Required) Yes No If yes, your site may qualify for additional protection from the state and for higher-level certification from us.Rare Species Description List any rare species here.Is your site being restored to natural habitat from agricultural or other use?(Required) Yes No Submit Your Native Plant List You must download the Certified Habitat Program Plant List, mark the plants in your property and upload it to this application. Download the Certified Habitat Program Plant List here. Upload Your Plant List FileMax. file size: 50 MB.Or list the native plants on the property hereHow many native plant species are on the property?(Required) What percent of the property is native plants?(Required) Habitat Certification Level(Required) Bronze: 25 native plant species or 25% of plants are native Bronze: 25 native plant species or 25% of plants are native Bronze: 25 native plant species or 25% of plants are native Which level are you applying for? To be eligible, all plants must be on your site. An upgrade in certification level is available at any time at no additional cost.