Blue Mountains Hunting Permit Application Form

BLUE MOUNTAINS HUNTING PERMIT APPLICATION FORM

docDM-97814 - RHA Application

Post To: Hunting Permits
Department of Conservation
P O Box 743
Invercargill 9840
Phone: (03) 211 2400 / Internal Correspondence

A FEE OF $11.50 WILL APPLY FROM 1ST SEPTEMBER 2013

All party members must be listed and incomplete applications may be rejected

Only One application per party/person. All multiple applications will be rejected.

If you are not able to hunt the block allocated to you, please advise us so we can issue it

to another hunter

1.  Applications close on the 1st of the month prior to the one you would like to hunt, ie February applications must be in by the 1st of January, March by the 1st of February, April by the 1st of March etc.

2.  The following block is only open during the weekends: TRAMWAYS

Area for which permit is required:

o Blue Mountains Recreational Hunting Area

MONTH ______WEEKEND or WEEKDAYS (circle preference)

DATES DESIRED ______or: ANY WEEKEND/ANY WEEKDAY

(USE BLOCK NAMES ONLY)

BLOCKS PREFERRED ______

______or ANY BLOCK

(List in order of preference, use all the spaces provided)

NOTE!!! PLEASE ADVISE OF ANY CHANGE OF ADDRESS AND INCLUDE THE CITY YOU ARE FROM. REMEMBER TO PRINT NEATLY – WE CAN’T PROCESS YOUR APPLICATION IF WE CAN’T READ IT!!

NAMES (Maximum four) / ADDRESS AND POSTCODE / Firearms Licence No. & Expiry Date

Number of Dogs ____ (Maximum four)

VEHICLE MODEL ______COLOUR ______REGN ______

SIGNATURE ______DATE __ / __ / __ PHONE ______

PAYMENT DETAILS: Cheque attached/Debit Card/ Credit Card Visa/ Mastercard

Card Number: ______Expiry Date: ______

Name on Card: ______Signature: ______

docDM-97814 - RHA Application

docDM-97814 - RHA Application