Empowered Dream Hunts Inc. Candidate Nomination Form
"Whitetail Hunts" or "Bear Hunt"
I'm nominating for a Whitetail or Bear hunt?
Was the candidate in the military or Law Enforcement?
Has the candidate applied with Empowered Dream Hunts Inc before?
If the candidate did go on a Dream hunt with us did you get a deer?
Has Candidate participated on a Disabled deer or Bear hunt before?
When? Where? What did they shoot?
Your answer
Has Candidate participated in the WI, 9 Day Disabled deer hunt program before?
Name of Person Making Nomination
Your answer
Nominator’s Phone Number(s)
Your answer
Candidate Name
Your answer
Parent(s) of Candidate (if under 18)
Your answer
Parent(s) or Candidate’s Phone Numbers, Address
Your answer
Parent or Candidate's Email Address
Your answer
Describe his/her condition/illness/special need/disability
Your answer
Is he/she in need of any assistance, Please explain (Hunter must have someone to assist them
Your answer
Has he/she taken a Hunter’s Safety Course
Safety Course When? Where?
Your answer
How many years of hunting experience?
Your answer
Has the candidate harvested a mature whitetail buck?
The candidate must meet the DNR'S Disable qualifications for a bear hunt/Transfer Tag. Go to www.dnr.wi.gov Do you meet these?
Has the candidate harvested a Bear?
Has the candidate ever received a bear transfer tag for?
Does the candidate have hunting land to hunt on?
Hunter must have someone come along on the hunt, and may stay more than one day.By signing this waiver you allow Empowered Dream Hunts Inc. to use your images for advertising.If you do not get picked this year, you must reapply next year. Deadline July 1st 2018
Electronic Signature of Candidate
Your answer
For more information, please call Joe or Laurie Ramsey at 715-693-3322 or 920-290-2108. Please send thisapplication to: Empowered Dream Hunts Inc. 526 Sandy Lane, Mosinee, WI 54455 or e-mailPlease visit us on our website or Face Book page: www.empowereddreamhuntsinc.org
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