Proposed Geographic Feature Name*:

State or Equivalent in which the feature is located *:

To select two or more, hold down Ctrl key while clicking mouse.

County or Equivalent in which feature is located *:

City, Town, Township or Equivalent in which feature is located:

Administrative Area in which feature is located (Forest, Park, etc.):

Action requested:*

Proposed New Name
Name or Spelling Change
Apply existing Name to Different Feature
OTHER If other, please explain:

Why does this feature need a name?*

Type of Geographic Feature(stream, mountain, populated place, stc.:

Is the feature identified (even by other names) in the Geographic Names Information System (GNIS)? Search GNIS

Yes
No
Unknown

Description of the Feature(physical shape, length, width, direction of flow, etc.):

Name Information(such as origin, meaning of the proposed name (required), historical significance,
biographical data [if commemorative -- no names for living individuals], or any other pertinent information):

Elevation:
Feet Meters

Specific Area Covered:
Latitude of the mouth or center of feature:
Degrees Minutes Seconds North South
Longitude of the mouth or center of feature:
Degrees Minutes Seconds West East
Latitude of the source of the feature, if it is a stream or valley:
Degrees Minutes Seconds North South
Longitude of the source of the feature, if it is a stream or valley:
Degrees Minutes Seconds West East

Public Land Survey System (PLSS) if applicable:
Section(s):
Township(s):
Range(s):
Meridian:

Maps and other published sources using the Proposed Name (Please include information to identify the
source, including scale of map [1:24,000, 1:62,500, etc.] if applicable, and date):
1.
2.
3.
4.
5.

Other names that have been or are used for this feature (Please include information to identify the source,
including name and date of the source, and scale of map [1:24,000, 1:62,500, etc.] if applicable):
1. Other name:
Source information:
2. Other name:
Source information:
3. Other name:
Source information:
4. Other name:
Source information:
5. Other name:
Source information:

Is the proposed name in local usage?

Yes No

If yes, for approximately how many years:

Is there local opposition or conflict regarding the proposed name?

No Yes

If yes, explain:

Additional Information:

Organizations or Individuals Which Support The Proposed Name:
Name:
Organization:
Street Address:
City, State, Zip:
Tel.: Cccupation: Years in area:

Name:
Organization:
Street Address:
City, State, Zip:
Tel.: Cccupation: Years in area:

Name:
Organization:
Street Address:
City, State, Zip:
Tel.: Cccupation: Years in area:

Proposed By: * = required field
Name *:
Street Address *:
City, State, Zip *:
E-mail Address *:
Telephone *:
Fax Number:
Title: Company or Agency: