Shaklee. Creating Healthier Lives.  

Dear Tree Planter,
The Environmental Protection Agency has asked us to collect data on the trees you plant so we can make every tree count.

To submit the form: Answer these questions and click the "submit" button at the bottom of the page. This will e-mail the data directly to us. Or if more convenient, print out this page or download the PDF version, answer the questions and fax it to 925.924.3603. Thank you!
   
Name (First & Last):
E-mail:
Phone Number:
Distributor ID:
Date Planted    [MM/DD/YYYY]:
Number Of trees planted:
Species:
Tree Size: Seedling
  5-Gallon Container
  10-Gallon Container
  15-Gallon Container
  Balled & Burlapped Evergreen

  Other    

Tree Height:

Location Planted: urban/sub-urban
  small town/rural

Location (City & State):

Describe Location (e.g. neighborhood park or school playground): 



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