Date of Encounter *Name *FirstLastAddress *City *State *Zip CodeCountry *Telephone *Date of birth *Email *Height *Weight *Sex *MaleFemaleActivity at time of encounter *Activity Experience Level *NoviceAccomplishedExpertDescribe equipment used in activity *Body Fully Clothed *YesNoType and color of clothing *Number of sharks observed *Indentified by *Description of shark *Location of encounter *Describe sea floorWeather conditions *Sea conditions *Water Depth *Time of Day *Water Visibility *Water Temp *Air TempTemperatures *EstimatedMeasuredLength of time in waterb prior to encounter *Kelp Present *YesNoAmount and location of kelp *Were marine animals present? *YesNoIf yes, location and number *Collection of marine animals prior to encounter? *YesNoType and method of collection *Describe in detail your movements prior to, during, and following the encounter. Include the shark's behavior, swimming movements, and persistence. *Sign-up to our newsletter?I understand that upon submission of this form I will have donated the above data to Shark Nark for ongoing white shark research projects including white shark/human interactions from the Pacific Coast of North America. I voluntarily donate this information to further our knowledge of the white shark and its interactions with humans. *YesSigned, *FirstLastEmail *NameSubmit