Personal Information
Full Name
*
Date of birth
*
Social Security Number
*
Hair color
*
Eye color
*
Height
*
Weight
*
Address Information
Street Address
*
City and county
*
State
*
Country
*
Enter your country
Postal Code
*
Phone
*
Home Phone
Email
*
Hunting & License Information
Shirt size
*
Select an option
Hunter Education Number (REQUIRED IF BORN ON OR AFTER JAN 1, 1975)
*
Driver's License Number
*
License Expiration Date
*
Have you hunted with us before?
*
Yes
No
Do you have a WV license?
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Yes
No
The following information is a DNR requirement for obtaining a WV hunting license if we are getting one for you:
Are you visually impaired?
*
Select an opAre you visually impaired?tion
Do you wear corrective lenses?
*
Do you wear corrective lenses?
Military Service
Combat Tours of Duty/Submit copy of DD-214/NGB-22 for verification:
*
Do you need any special accommodations?
*
Submit