United Bowhunters Of Pennsylvania
Disabled Hunters Program


Hunter Application



* Name:
* Address:
* City:   * State:
* Zip:     * Phone:
Email Address:

* Gender:
    Male
    Female

* Age:

* Years of Hunting Experience:

* Number of Years Disabled:

* Have you ever participated in one of our hunts?
    Yes
    No

* Are you a United States Veteran?
    Yes
    No

Choose your income level:
    $15,000 or less
    $15,000 - $30,000
    $30,000 - $45,000
    $45,000 - $60,000
    over $60,000

* Number of deer taken since disabled:

Describe your disability:


* Are you in a wheelchair?
    Yes
    No

* Can you be easily transferred into a 4WD or ATV for transporting?
    Yes
    No

Please list any other limitations the outfitter should know about (eg. Can't navigate stairs; require ADA compliant bathroom facilities, etc):


Please tell us about any Travel Restrictions you may have (eg. Can't fly, Can't drive over 300 miles, etc):


* What style of bow do you shoot?
    Traditional
    Compound
    Crossbow
    Don't Shoot a Bow

* Do you have a Hunter Trapper Safety Certificate?
    Yes
    No

* Have you taken the Bowhunter Education Program?
    Yes
    No

* Are you a member of the UBP?
    Yes
    No

How did you hear about the UBP Disabled Hunter Program?






* indicates a required field.