Goose Egg Oiling/Roundup Form

2. Goose Egg Oiling/Roundup Form

   Please fill out this form with your name, address, email, and phone number. Select whether you are opting in or opting out of the goose egg oiling roundup program. Please allow 2-3 weeks for processing time.

   Please fill out this form with your name, address, email, and phone number. Select whether you are opting in or opting out of the goose egg oiling roundup program. Please allow 2-3 weeks for processing time.

4. Owner First Name*

5. Owner Last Name*

7. Address of Property*

9. City, State, Zip Code*

11. Owner Email

12. Owner Phone Number*

14. Options*

    1. I consent to good egg oiling and roundup.
    2. I would like to be removed from the list.

16. What am I consenting to?

    By consenting to the egg oiling and roundup, you are allowing City and State officials to enter your property to complete BOTH the egg oiling and roundup performed by the USDA. By asking to have your name removed from the list, you are asking to have your name which was previously on the list removed. No egg oiling or roundup will occur on your property.

    By consenting to the egg oiling and roundup, you are allowing City and State officials to enter your property to complete BOTH the egg oiling and roundup performed by the USDA. By asking to have your name removed from the list, you are asking to have your name which was previously on the list removed. No egg oiling or roundup will occur on your property.

18. If you would like more information on egg oiling and roundup, please email Kent Attwell at kattwell@ci.delafield.wi.us.

    If you would like more information on egg oiling and roundup, please email Kent Attwell at kattwell@ci.delafield.wi.us.

20. USDA

    www.usda.gov

    More information can be found at the United States Department of Agriculture website.

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22. 1. Receive email copy
23. Email address

    This field is not part of the form submission.

24. Submit

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