Scott Walker, Governor
Cathy Stepp, Secretary

Telephone 608-266-2621

Toll Free 1-888-936-7463

TTY Access via relay - 711


State of Wisconsin

DEPARTMENT OF NATURAL RESOURCES

101 S. Webster Street
Box 7921
MadisonWI 53707-7921

Page 1

NOMINATION FOR THE SPORTING HERITAGE COUNCIL

BEAR HUNTING INTERESTS

2011 Wis. Act 168 established the “Sporting Heritage Council” to provide advice to the Governor, Natural Resources Board (NRB) and Legislature on fishing, hunting and trapping issues, primarily related to recruitment, retention, and increasing access to resources for these participants.

The Sporting Heritage Council consists of 12 appointees, including the DNR Secretary or their designee, one member appointed by the Governor, two members of the Assembly, two members of the Senate, one member appointed by the Conservation Congress Executive Committee and five members appointed by the NRB. Of the members appointed by the NRB, one is to represent the interests of deer hunters, one for bear hunters, one for bird hunters, one for anglers, and one for those that pursue furbearers through trapping or hunting. Individuals are to be appointed to 3 year staggered terms.

To be considered, for this position,please complete the nomination form below.

Name of Nominating Organization:______

Are you submitting this form as an official designated to represent this organizations? Yes No

Nominee’s Information

Name (First, Middle Initial, Last):
Home Address 1:
Address Line 2:
Home Phone: Cell Phone:
E-mail Address: Date of Birth:
Work Address 1:
Address Line 2:
Work Phone: Fax Number:
Preferred Mailing Address (please check one) Home Work
What is your state of residence?
Are you an elected official? Yes No
If yes, what is your position?

The Following Demographic Information Is Optional

Disability: / Veteran:
Sex: Male Female / Ethnicity:

Which local, statewide or national hunting, fishing or trapping organizations is the nominee currently an active member of?

Organization / Do you Serve on the Organization’s Leadership Board? (Y/N) / If Yes, what is your position?

In the space provided below, please list the names of three people who are willing to serve as references for the nominee.

Name / Phone Number / Relationship to Nominee
1.
2.
3.

Please attach a copy of the nominee’s resume to this application. Please include all relevant work experience, education, community involvement, government or military service, honors, awards and other talents.

Please attach a separate document of 250 words or less to describe why the nominee is exceptionally well suited to represent bear hunting interests. Also explain how well the nominee would address the specific areas of emphasis for the Sporting Heritage Council as specified in s. 29.036(1), Stats., which include 29.036(1)(a)ways to: (a) improve the recruitment and retention of hunters, trappers, and anglers; (b) improve 29.036(1)(b)the management and protection of the natural resources of this state for the purposes of hunting, trapping, fishing, and other types of outdoor recreation activities; (c) 29.036(1)(c)encourage youth to participate in outdoor recreation activities, including ways to implement outdoor recreation programs for youth; (d) improve 29.036(1)(d)access to public and private land for hunting, trapping, fishing, and other types of outdoor recreation activities; (e) improve 29.036(1)(e)public access to lakes; and (f) 29.036(1)(f)increase the availability of public shooting ranges.

Submitted on Behalf of ______(Organization)

Name of Nominating Officer______Title/Position______

Signature______Date______

Applications and attachments can be e-mailed to:
/ Or, applications and attachments can be mailed to:
Wisconsin DNR
Attn: Diane Greisinger
101 S. Webster Street
Madison, WI53702

By submitting this application you are affirming that all the statements you have made in this document are true and that you understand that a background check may be conducted if you are considered for appointment.

Under Wisconsin Statutes 19.36(7)(b), as applicant for this position, you have the limited right to request that your identity be kept in confidence. If you wish to preserve this right, you must attach to your application a letter requesting confidentiality of your identity with respect to this application.

This right prevents your identity from being released in response to a public record request unless; you are appointed to the position or you are a finalist for the position as defined by Wisconsin Statute 19.36(7)(a).