E-VERIFICATION FORM

If you have comments or questions, please let us know. We regret that we may not be able to respond promptly to all questions (we are a committee of volunteers). You may Email the Zebra Mussel Committee directly at: lwzmcommittee@gmail.com

Please make sure all the required fields are filled in and that all the boxes are checked. DO NOT USE AUTO-FILL.

After you click "Submit" this screen should update to a message saying "Thank you, your information has been submitted." If you do not receive this message (right below this paragraph,) please use the printed form or try again later. Please type in the information, we have found the form does not respond well to Auto-fill. Thank you for your patience.

Electronic Verification Form 2025

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

I agree to do my part to prevent the introduction of zebra mussels into Lake Waukomis. (Please check all boxes.) *

I won't use my equipment in other lakes, streams, or other bodies of water. I won't allow my guests to bring equipment into the lake. Educate my guests about Zebra Mussel Prevention. If I have equipment that has been used outside of Lake Waukomis, I will ensure that it has been cleaned and drained outside our watershed, and kept out of our water until it has dried for the specified amount of time according to the chart in ZM regulations. Any motorized boat will be inspected prior to entry. Used dock equipment is prohibited.

Please list number of docks, boats, small watercraft (eg kayak, paddleboard, etc.) used on Lake Waukomis. This helps determine the number of stickers you will receive. *

Submit

Electronic Verification Form 2025

Keep Lake Waukomis Healthy and Beautiful!