Free Bird Hunt Application.xls - Indiana

Indiana Department of Natural Resources State Form 52672 (R2 / 4-08)

Pheasant, Dove, Migratory Gamebird & Military/Refuge Deer Hunt Application
Please fill in your name and address below as well as the required information for the hunt(s) of your choice. Please read the instructions prior to completing this form. You may use this application to apply for one, two or all three hunts together. However, applications will not be accepted before July 1, 2008. Mail your completed application to: IDNR Reserved Hunts; 402 W. Washington St. W160A; Indianapolis, IN 46204.
Last Name First Name Initial

Address

City

State

Zip

Email Address

Date of Birth Month Day Year

Check One: Resident license Non-resident license

Pheasant Hunt Application
INFORMATION REQUIRED
Current Indiana Hunting License Number and type: License Number: Hunting Hunting and Fishing Lifetime Comprehensive Hunting Lifetime Comprehensive Hunting and Fishing Youth Consolidated License Other Regular Hunt Nov. 7, 2008 Nov. Nov. Nov. Nov. 8, 2008 12, 2008 15, 2008 19, 2008 Nov. 23, 2008 Dec. 6, 2008 Dec. 13, 2008 Dec. 20, 2008 Select only ONE date:

Due: September 19, 2008
Youth Hunt* Nov. 28, 2008 *Only hunters younger than 18 years of age may apply for the youth hunt. A youth hunter applying for the youth hunt may not apply for a regular hunt. Select only ONE hunt.

Reserved Dove Hunt Application
INFORMATION REQUIRED
Current Indiana Hunting License Number and type: License Number: Hunting Hunting and Fishing Lifetime Comprehensive Hunting Lifetime Comprehensive Hunting and Fishing Youth Consolidated License Other Roush Lake Mississinewa Reservoir Salamonie Reservoir Blue Grass FWA Kingsbury FWA Pigeon River FWA

Due: July 18, 2008
Select ONE property where you wish to hunt:
Winamac FWA Hardy Lake FWA Jasper-Pulaski FWA Kankakee FWA LaSalle FWA Willow Slough FWA

Military/Refuge Deer Hunt Application
Driver's License No. (unless you are without one) Military/Refuge Gun Hunt Code No. First Choice

Due: August 15, 2008
Military/Refuge Bow Hunt Code No. First Choice Second Choice

INFORMATION REQUIRED
Second License Number: 2008 resident deer license 2008 non-resident deer license Lifetime license Youth license Choice

NOTE: A partner is required on Big Oaks NWR.