CHAMPIONSHIP TREE FORM 

MONTGOMERY COUNTY
NOMINATION FORM

Name:_____________________________________________

Street Address:______________________________________________

  ______________________/___________/___________/_________________
               City                                  State                  Zip                  Telephone

Location of Tree: ____________________________________________

  _______________________________________________________________

Species of Tree (If Known): ___________________________________

Height (In Feet): _______________

Width (Spread) of the Crown of Tree (In Feet): ___________

Circumference around trunk at 4.5 feet above ground level (measured in inches): _____

Nominator:   

Name:_____________________________________
Address:______________________________________
                _____________________________________
                _____________________________________
Phone:  ______________________________________

PRINT THIS FORM

Please send nominations to:

Montgomery County Forestry Board
Chamption Tree Program
17400 Annapolis Road Road
Woodbine, MD 21797
Tel: (301) 854-6060
Fax: (410) 442-2126