CAPTIVE BREEDING PROGRAM
SOUTHERN
EMU WREN
(Stipiturus
malachurus)
REPORT: / /___
NAME:_____________________________________________
ADDRESS:___________________________________________________________________
SIGNED:
CURRENT NUMBER HELD:
.
SEX: (M)
SEX:
(F)
DID YOU HAVE ANY FATALITIES
SINCE YOUR LAST REPORT: (YES)
(N0)
IF YES, STATE NUMBER LOST:
.. DATE(S)LOST(1)
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../
..(2)
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..
SEX:
..
WHY? (IF KNOWN):
.
DID ANY BIRDS NEST OR SHOW
SIGNS OF NESTING
SINCE YOUR LAST REPORT: (BUT
NO YOUNG FLEDGED)
(YES)
(NO)
IF YES, DID THEY BUILD A NEST
:
(YES)
(NO)
.... HOWMANY
.
DID THEY LAY EGGS:.
(YES)
(NO)
. HOWMANY
DID ANY EGGS HATCH: (YES)
(NO)
HOWMANY
.
DID ANY YOUNG DIE IN THE
NEST: (YES)
(NO)
HOWMANY
.
___________________________________________________________________________________
DID ANY BIRDS BREED SINCE
YOUR LAST REPORT:
(YES)
(NO)
IF YES, NUMBER FLEDGED:
..
DATE(S) FLEDGED:(1)
./
../
..(2)
../
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..
(3)
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..(4)
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../
..
SEX: (IF KNOWN)
..
CURRENT CONDITION:
..
SINCE YOUR LAST REPORT, IF
ANY BIRDS NESTED OR SHOWED SIGNS OF NESTING, PLEASE GIVE A BRIEF DESCRIPTION:. (Eg. Species of plant, Nesting material, ect..)
___________________________________________________________________________________
GENERAL COMMENTS: Please use
back of form for any general comments.
Form designed & produced
by The Softbill Group of WA.