Fellowship Actions Impacting the Habitat

(F.A.I.T.H.)

Application for Certification

The North Carolina Wildlife Federation’s F.A.I.T.H. program is a non-denominational program designed to recognize places of worship that meet crucial requirements for a wildlife-friendly habitat. Encouraging stewardship practices, which help to foster an appreciation and awareness of wildlife, habitat, and conservation are additional components of this faith-based initiative.

Contact Information

Place of Worship: ________________________________________________________________

Address: ________________________________________________________________________

________________________________________________________________________

Phone: _________________________________________________________________________

Website/E-mail: __________________________________________________________________

Congregation Leader: _____________________________________________________

Congregation Size (members): ______________________________________________________

Habitat Team Leader (Name/Phone/E-mail): _________________________________________

_______________________________________________________________________________

What is the size of the property (in acreage)? _________________________________________

Habitat Components

Plant List

Plant communities form the foundation for all wildlife habitats. Please circle all present and list as many individual species as possible (please attach list if necessary):

a. Vines	f. Wildflowers
b. Evergreen trees	g. Ferns
c. Deciduous trees	h. Aquatic plants
d. Evergreen shrubs	i. Grasses
e. Deciduous shrubs	j. Ground covers
	k. Other____________________________

Individual species: ______________________________________________________________

_______________________________________________________________________________

Food Sources

Plants should be the main source of food in your habitat, however feeders are a great supplemental source of food. What types of food are present within your F.A.I.T.H. site? Circle all that apply.

e. Squirrel

f. Other _____________

Plant foods:	Feeder Types:
a. Seeds	a. Tube
b. Nuts	b. Suet
c. Berries	c. Hummingbird
d. Fruits	d. Platform
e. Nectar	e. Squirrel
f. Pollen
g. Foliage/twigs
h. Other ____________________

Water Source

Clean water is needed by all wildlife for drinking and bathing. What water sources are provided on site? Circle all that apply.

a. Birdbath	f. Waterfront (lake or river)
b. Water garden/pond	g. Coastal
c. Stream	h. Puddling area
d. Wetland area	i. Seasonal Pond
e. Spring	j. Other _______________________

Shelter and Places to Rear Young

Shelter from weather and predators is important for wildlife survival. To provide a complete habitat, wildlife must also have places to rear their young. How does your site meet these needs? Circle all that apply.

Shelter:	Rearing Young:
a. Rock pile	a. Mature Trees
b. Brush pile	b. Snags (trees with cavities)
c. Ground cover	c. Host plants for butterflies
d. Wooded area	d. Dens
e. Meadow/Prairie	e. Dense shrubs/thickets
f. Evergreens	f. Water garden/pond
g. Log pile	g. Meadow/prairie
h. Dens	h. Wetland
i. Water garden/pond	i. Roosting/Nesting Box
j. Dense shrubs	j. Evergreen trees/shrubs
k. Roosting/Nesting box	k. Bee house
l. Other _____________________	l. Other ___________________________

Nest Boxes

Please list the different types and #’s of nest boxes found on your site. _____________________________________________________________________

___________________________________________________________________

Wildlife Species List the species of wildlife documented on your site:
_______________________________________________________________________________

_______________________________________________________________________________

Stewardship Projects

What additional conservation stewardship projects are included on your site?

a. Reduction of fertilizer use	g. On-site recycling
b. Removal of invasive plants	h. Project Feeder Watch
c. Reduction of lawn maintenance areas	i. Project Frogwatch(citizen monitoring)
d. Reduction of pesticide use	j. Adopt-a-Stream/Big Sweep
e. Interpretive nature trail	k. Other __________________________
f. Nest box monitoring

Long-Term Success of F.A.I.T.H. Program

(Attach additional pages where necessary)

The F.A.I.T.H. program is intended to grow and to inspire stewardship within the congregation and in the community. How will your site continue to evolve, educate and inspire in coming years? _____________________________________________________________________________________

_____________________________________________________________________________________

Please list the projects the F.A.I.T.H. Team would like to work towards accomplishing in subsequent years (include a timeline): ______________________________________________________________________________________

______________________________________________________________________________________

Should the lead member(s) of the F.A.I.T.H. team leave the congregation, what plans are in place for sustaining site wildlife projects and conservation objectives? __________________________________

______________________________________________________________________________________

How will the successes and benefits of the F.A.I.T.H. program be shared with the members of the congregation and/or the community? ____________________________________________________

______________________________________________________________________________________

Maintenance Plan

Briefly describe your year-round maintenance plan, who does it include? (groundskeeper/committees/volunteers): _______________________________________________________________________________________ _______________________________________________________________________________________

Visual Documentation

Please include a sketch/diagram of the grounds (include building locations, foot traffic patterns, areas of water run-off, feeder stations, nest boxes, various garden areas, etc…)

Optional: Include pictures of your F.A.I.T.H. site.

Include congregational comments of support for the F.A.I.T.H. efforts on site.

*Please note that any pictures or letters of endorsement submitted to the North Carolina Wildlife Federation will be retained for documentation and promotional purposes.

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Mail to: NC Wildlife Federation

2155 McClintock Road

Charlotte, NC 28205

Include $30.00 (made out to NCWF) for processing - Includes certification, a 1-year NC Wildlife Federation membership and information for ordering a handsome certification sign.

For NCWF office use only:

Code _______________

Approved by________________
Date Received _______________