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Apply for Outdoor Adventure

Apply for Outdoor Adventuretechknow2021-01-21T20:54:37+00:00

First Name *

Last Name *

Street Address *

Street Address 2

City *

State/Region *

Postal/Zip Code *

Country *

Phone *

Email *

Is the hunter active or retired military? *

Yes

Does the hunter possess any of the following? *

State Issued P2A Disability Card (or related materials)

Hunter Education Card (only if born after January 1, 1980)

Firearm Owner Identification (resident hunters) please include number below

State Issued Habitat Stamp (required for all hunters unless under the age of 16)

Fishing License

FOID Card Number

Is the hunter confined to a wheelchair (non-ambulatory)? *

Yes

Would you anticipate using a motorized or non-motorized wheelchair to get to a blind? *

Yes

Please describe the exact nature of any disability and/or major health problems: *

Name of the person nominating the hunter and their contact information (phone, email, etc)? *

What kind of adventure would the nominee prefer? *

Is this a surprise to the nominee? *

YES

If you are human, leave this field blank.

JBF Contact
PO BOX 132
Bartelso, IL
62218

[email protected]

Apply for Outdoor Adventure

Interested in becoming a future candidate, or would like to nominate an individual?
Please fill out our online form at the link above or print out your form HERE and return to our listed address.

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Apply for Outdoor Adventure

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