Vernal Pool & Rare Species (VPRS) Reporting System
Observer Information and Certification
*USER ID:
*Name:
*Permanent Address:
*Email Address:
*Telephone:
Affiliations/Qualifications:
I hereby certify under pains and penalties of perjury that the information submitted through the VPRS
system to the Natural Heritage & Endangered Species Program is true and complete to the best of my
knowledge.
*Signature: _____________________________________________ *Date: ______________
Signature of adult if observer is under 18 years of age:
________________________________________________________ Date: ______________
To establish your VPRS electronic signature, please print and sign this form. Please return this form to:
Data Manager - VPRS
Natural Heritage & Endangered Species Program
Massachusetts Division of Fisheries & Wildlife
1 Rabbit Hill Road
Westborough, MA 01581
OR: ContactVPRSAdmin@state.ma.us
Note: All fields marked with an asterisk (*) are required.
