To receive your award you must snail mail your check to:

Jeff Blystone
2804 N. Union School Rd.
Independence, Mo. 64058
816-806-3574

Not over 8 of the points neccessary to win the Small Game Award may be made on any of the above indicated by *

First Name

Last Name

Street

City, State, Zip

Email

Phone # (3145551212) no spaces

Age

 

 

Not over 15 points may be made on any single kind of game.

Not over 23 points on any 2 kinds of game

All kills must be reported to the Chaiman within 90 days

A  fee of $2.00 must accompany the first application for the Small Game Award

Select

Quantity

Badger, 6 points

Bullfrog, 1/2*

Groundhog, 6

Opossum, 2

Rabbit, 3

Raccoon, 5

Skunk,
  (striped only) 2

Squirrel, 4

Weasel, 4

Crow, 6

Dove, 5

Duck, 5

Goose, 5

Pheasant, 3

Quail, 3

Legal Fish, 1

Turtle, 1
  (not Terrapin)

Gar, 2
(must be landed)

<<< Enter EXACT Code, Case Sensitive

Small Game Report/Award Submission Form

..

 

 

ALL
REQUIRED