AAW Equipment Reservation Form - Individuals and Organizations

Please review all the required forms listed under the "Requirements" tab and discussed on the Reservation page: http://www.accessabilitywi.org/reservations

The OWC weighs 350 lbs. and is loaded on a trailer weighing approximately 800 lbs. that uses a 2” ball. Please make sure you will have access to a vehicle with the capacity to tow equipment over 1150 lbs. when you make the reservation. For safety reasons we require at least an 8" clearance from the ground to the hitch once the trailer is attached. As such we suggest you use a midsize SUV, a van, or a truck to ensure the appropriate clearance and safety. We have a right to refuse check out for any safety reason. 

***We have a right to refuse check out for any safety reason.***

Phone: 608-886-9388 - www.AccessAbilityWI.org - Email: AAW@AccessAbilityWI.org

Email address *
Full Legal Name of person checking out AAW's outdoor wheelchair(s) *
Your answer
Please provide WI DNR Customer #: of person checking out the outdoor wheelchair(s) *
Your answer
We require this due to DNR grant reporting. If you have questions about the WI DNR Customer #, please refer DNR- http://dnr.wi.gov/education/outdoorskills/idcheck.html
There is no fee to acquire a DNR Customer #.
Street Address *
Your answer
City, State, & Zip *
Your answer
Phone: *
Your answer
Kind of phone *
Is the person using the chair a minor: *
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