You Can Download This Form from the Participants' Websites

www.ark.eu www.eurosite.org www.freenature.eu www.wnf.nl

You can download this form from the participants' websites

Nomination of sites for the

Wild Europe Field Programme

Yes, I have read the brochure “Wild Europe Field Programme” and I think there definitely are possibilities to develop new nature in large regions in the next twelve years. Therefore I would like to ask your attention for an area where this initiative could be implemented in the future. ARK/FREE/WWF/Eurosite will contact me if they agree it is a good potential project, to discuss my nomination further.

Name:

Organisation:

Tel. number:

Email address:

For your information by separate mail (or as an attachment to this form) I will send a map of the proposed region and I have answered the next questions:

Characteristics of the proposed region

1.  name of the region:

2.  protected areas in the region; name & size:

3.  the region is (partially) a Natura 2000 site: yes / no

4.  the region contains the following habitats: forest / freshwater wetlands / marine / meadows / mountains / intensive agriculture / extensive agriculture / pastures

5.  I estimate the area of the region suitable for nature development to be……… ha

6.  the region has or will have a lot of abandoned agricultural land for which a nature development purpose could be an interesting alternative economic option for the local communities: yes / no

7.  the region is bisected by one or more major infrastructural works (e.g. super highways, high speed railways, hydropower dams): yes / no

8.  there are about ……. (estimated number) people living in the area

9.  local people in the region are leaving the rural areas: yes / no

10. there are towns and villages in the region, namely:………

11. the nearest city (10,000 inhabitants) is less than …... km away, namely:………

12. in the last five years there have been serious forest fires in this region: yes/no

13. big wild herbivores or semiwild herbivores live in the region, namely:……..

14. predators and scavengers live in the region, namely:………

15.  some herbivores, predators, scavengers or other key-species are missing, namely:……….

16.  in the next 6 years there are good perspectives for (re)introduction of the following species:…………..

Other characteristics

17. my organisation is a Governmental institution / international NGO / national NGO / local NGO

18. the main type of economic activity in the region is……………

19. possibilities for own financial funds: yes/no

20. there is support for the ideas for wilderness by local people: yes/no

21. there is support for the ideas for wilderness by local and regional policymakers: yes/no

22. please name a few of the stakeholders:……………..

For your further information, I will write some explanatory notes below using no more than two pages.

Thank you very much for your attention and I am looking forward to hear from you before 1 October 2009 so we can discuss the possibilities this region has to offer for the Wild Europe Field Programme!

Please mail this form and map preferably before 1 August 2009 to:

or send it by regular mail to: FREE

Obrechtstraat 33,

6815 BN Arnhem,

Netherlands