Shark Encounter Form

Date of Encounter    

First Name			Last Name
Address
City		State		Zip
Telephone		Country
Date of Birth
email
Occupation
Height	Weight	Sex  Male        Female
Longitude		Latitude
Activity at time of encounter
Experience level at this activity      Novice        Accomplished     Expert

Describe type and color of equipment used in this activity

Body fully clothed?   Yes    No	Color of exposed skin
Type and color of clothing

Number of sharks observed

Identified by

 Description of shark:

Location of encounter
Describe ocean floor at encounter location

Weather conditions
Sea conditions

Water depth at encounter location				Time of day
Water visibility
Water Temperature		Air Temperature		Estimated    Taken

Length of time in water prior to encounter
Kelp present at encounter location		Yes   No
Amount and location of kelp
Were marine mammals present at enounter location			Yes   No

If yes, location and number of mammals:

Collecting of marine animals prior to encounter

Yes   No

Type of animals and method of collection:

Describe in detail your movements prior to, during, and following the encounter.  Include the shark's behavior, swimming movements, and persistence.

I understand that upon submission of this form I will have donated the above data to Ralph S. Collier and/or the Shark Research Committee for their ongoing white shark research projects including white shark/human interactions from the Pacific Coast of North America.  I voluntarily donate this information to further our knowledge of the white shark and its interactions with humans.

First Name			Last Name
Address
City		State		Zip
Telephone		email