Exotic Longhorned Beetle Report Form

*Date of beetle sighting (approximate is fine)

*Location of beetle sighting (street address or intersection, town)

*Description of beetle (size, shape, color, etc.)

Types of trees nearby (e.g. pine, oak, maple, etc.)

Do you have the beetle? yes
Do you have a picture of the beetle? yes

*Your name

Address

*Town

*State

*Zip

Phone

*Email