All fields in red are required.
Time:Enter time in the format HH:MM am/pm
If you are unable to input GPS coordinates, your browser may not have location services enabled. Please temporarily enable location services for the browser in your settings so it may enter GPS coordinates into the GPS fields.
Must be latitude in decimal degrees (e.g., 43.1030272)
Must be longitude in decimal degrees (e.g., -89.50251519999999)
Brief Description of where you collected the sample:
e.g., Door knob, handle bars, playground bars, kitchen counter, gas station pump, etc.
Photo of sampled location (jpg files only):
Once you click submit, you cannot change the data. Please verify all sample fields before submission.