TRAPPING, BEAR, AND SMALL GAME REGISTRATION FORM

FOR NATURE CONSERVANCY PRESERVES IN WISCONSIN

Date: Click here to enter a date.

Name: Click here to enter text. Street: Click here to enter text.

City: Click here to enter text. State: Click here to enter text. Zip Code: Click here to enter text. E-mail: Click here to enter text.

Phone number: Click here to enter text. License Plate Number: Click here to enter text.

Will you be under the age of 18 at any time during the hunting season? Yes ☐ No ☐

If Yes, Date of Birth? Click here to enter text.

Have you been cited with a DNR violation within the last five years? Yes ☐ No ☐
If yes, what violation? Click here to enter text.

☐ Check here to allow TNC to share your contact information (name, phone, e-mail) with other trappers or hunters at the same Preserve, so that registered users can communicate and coordinate hunting and trapping locations.

To be completed by REGISTRANT – Please check the activity and preserve you are registering for:
☐ Bear hunting ☐ Small Game ☐ Trapping
Preserve:
☐ Barneveld Prairie (map) – Iowa County
☐ Baraboo Hills (map of specific tracts) – Sauk County
☐ Catherine Wolter Wilderness Area (map of specific tracts) – Vilas County
☐ Chiwaukee Prairie (map) – Kenosha County
☐ Lower Chippewa River (map) – Buffalo County
☐ Mink River (map of specific tracts) – Door County
☐ Mukwonago (map of specific tracts) – Walworth/Waukesha Counties
☐ North Bay (map of specific tracts) – Door County
☐ Shivering Sands (map of specific tracts) – Door County
☐ Spring Green (map of specific tract) – Sauk County
☐ Thomson Prairie (map) – Dane/Iowa Counties
Species to be harvested and method used: Click here to enter text.
To be completed by THE NATURE CONSERVANCY
Form number ______

Please completely fill out this form, answering all questions; registration is optional. Return this completed Registration
Form by email to or by MAIL to:

The Nature Conservancy
633 West Main St.
Madison, WI 53703

Forms will only be accepted by e-mail, U.S. Mail or other parcel service, and should not be hand delivered or dropped off at a Conservancy office.

To protect your privacy, please do not include sensitive personal information in this form. When using this form, you should never submit confidential financial or personal information, such as a credit card number.