Your address
E-mail address
Name of site
Please state if the site is publicly accessible
County of site
Ordnance Survey Grid Reference (two letters and six numbers)
For new sites, please draw a sketch map overleaf showing the location of the site in relation to roads, railways and other nearby landmarks, and show the area which you have searched (either the boundary of the area or the path which you walked). Please also mark the approximate position of the glow worms and give an idea of the scale.
Details of visits
| Date of visit | Time | Conditions* | No. of females
(glowing) |
No. of males | No. of larvae |
Continue on a separate sheet if necessary
*Choose from: Dry, Raining, Wet ground (ie droplets on vegetation),
Windy. Also give night time temperature if you can.
Type of site (please tick):
| Nature reserve | Garden | Roadside | Railway | Waterside | Sea cliff | Quarry | Grassland | Other |
Position of glow worms (tick more than one if necessary):
| Short grass | Long grass | Under trees | In hedge | On path | On gravel or stones | Other |
Is there any permanent open water within 100 metres of the glow worms?
| No | Stream or ditch | Pond | Lake | River | Canal | Sea |
Are you aware of any chemicals used on the land?
| Definitely not | Yes: weedkillers | Yes: insecticides | Yes: slug pellets | Don't know |
Is the area grazed?
| No | Sheep | Cattle | Horses | Rabbits | Deer |
Is there a slope or open aspect to the site?
| No | Yes: N | NE | E | SE | S | SW | W | NW |
Artificial lighting:
| None | Distant lights: over 200 m | 50-200 m | Bright lights nearby | House lights only | Lights from passing traffic |
Any other comments about the site
(eg early records of glow worms not previously reported, changes in
use of the site either in the past or planned)
Please return this form to
Robin Scagell, 34 Fennels Way, Flackwell Heath, High Wycombe, Bucks HP10 9BY