**Please Print this form, fill it out and return it with your payment **

HORICON MARSH GOOSE HUNT

QUALITY GUIDED HUNTS ON PRIVATE FARMS

Three Day Hunt

Sat., Oct. 09, Sun., Oct. 10, & Mon., Oct. 11, 2010

                                                                   Wisconsin DNR sets the goose tag limit per day.

                                

Come on out, have a fun weekend and enjoy guided hunts on private farms.

 

THREE DAY HORICON MARSH GOOSE HUNT - $600.00 

 

 

This hunt closes based upon the

first 50 hunters to make a deposit!

NO REFUNDS AFTER AUGUST 1, 2010

 

ACCOMMODATIONS INCLUDE:

 

For Reservations or Information, Please Call

Don Roberts (219) 322-1545

or write to

WATERFOWL U.S.A.

1707 S. Cline Ave., Griffith, IN 46319

www.nwiwusa.com

 

 

 

           

WATERFOWL U.S.A.

Northwest Indiana Chapter

20010 Horicon Goose Hunt Application

October 09, 10, and 11, 2010

Please print or type the following for DNR goose permit application purposes only. We do not sell or circulate this confidential information.:

 

Name:

_____________________________________________________________________________

First                                         Middle                                                    Last

 

Address:

_____________________________________________________________________________

             City:                                                   State                                                            Zip

 

(______)- _____________-____________           _____________________________________

Phone:                                                                    Birth Date:

 

____________________    __________________     _______________     ________________

Hair Color                            Eye Color                         Weight                         Height:

 

Social Security Number

Required by WI DNR    ___________- ___________-___________

 

 

_____________________________________________________

Email Address:

 

 

Please provide Name of Room Sharing Person(Partner): Single rooms will incur an additional

fee and are limited and assigned on a first hunt deposit received basis.

 

 

Please Check Type of Room. _________Smoking     __________Non Smoking

 

 

 

Signature_____________________________________________________________________

 

 

Note: Layout Blinds May Be Used If Fields Dictate

 

 

Please Return completed application with deposit of $300.00 payable to:

 

Waterfowl U.S.A

Northwest Indiana Chapter

1707 South Cline Avenue

Griffith, Indiana 46319