Hunter Mentor Program Special Authorization

This document serves as confirmation that the person listed below is registered in the Hunter Mentor Program. Print this document. Mentee must carry this document at all times while in the field. This document must be signed by mentee, parent/guardian if mentee is under 18, and mentor. Print out and sign a new copy of this authorization for each participating mentor.
Mentee Name:		Mentee DOB:
Mentee Address:		Mentee Age:
		Sportsman ID:
Issue Date:		Expiration Date:

Mentee Signature		Date
	I swear or affirm that the information given by me is true and correct.
Parent/Guardian Signature		Date
(if mentee is under 18)	I swear or affirm that the information given is true and correct and I agree to allow my child to obtain a special authorization to hunt.
Mentor Signature		Date
	I swear or affirm that I meet the requirements to be a hunter mentor as specified in Section 3(e).

Mentor hunting license type and number
Mentor hunter safety certification number