EmailMe Form - Port Aransas Application

Name (Do not start this application if it is not for a specific listed Port Aransas Fishing Trip on our Facebook or Website. We DO NOT accept random applications.) *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Current County *

Date of Birth *

Phone *

### - ### - ####

Confirm

### - ### - ####

Email *

Re-Type Email (must match)

Confirm

Multiple Choice *

Applying as a couple

Applying for just yourself

No Buddies, or Children allowed to be considered when applying as a couple. Must be your Husband, Wife, Boyfriend, Girlfriend, etc.

This box is required ONLY for Veterans applying as as couple. If applying for just yourself, leave blank. Please advise if you would be interested in us considering you for the individual Veteran section if the couples section of our trip is filled.

Have you fished with HwS before? *

Yes

No

Have you hunted or fished with any other Organization? *

Yes

No

If the answer is yes, what Organizations? When & Where (If you went out more than once with an Organization, include all adventures you went on)

By Checking the YES Box, you agree that your statements of who you have been out with, and how many times are accurate and true. That you have NOT left any Organizations out? And also that all other information on this application is correct and truthful? You understand that you are responsible for being truthful and honest. You also understand that any information found to be untrue, or not added (intentionally left out to gain a benefit) can result in criminal charges. We believe in getting all Veterans out, we just want all to be absolutely honest. We do not look to prosecute Veterans. We only want to make sure we help those in need who are honest. *

Yes

No

Military Branch *

Status *

Active Duty

Disabled

Reserve

Veteran

If Disabled, what accommodations (if any) you would require to make an outing comfortable and successful.

Dates of Military Service *

If no longer in the Military, Discharge Status. If not Honorable, Explain at bottom where it says tell about yourself. If no explanation for anything other than Honorable, your application will be deleted. *

Current or Last Rank *

Were you in "Active Combat" in any Military Campaign? *

Yes

No

In this section, DO NOT abbreviate. If yes, were you in "active combat" or in a combat zone away from the actual combat? Give detail about your deployments. If not in active Combat, did you directly deal with the wounded or deceased as a result of combat? Explain if yes.

When? Where? Etc. *

Tell us a little about yourself. Also if applying as a couple, put the other persons name here, and how they are related to you. *

NAME AS IT APPEARS ON FACEBOOK IF DIFFERENT THAN NAME ABOVE (This is so we can tag you). If no Facebook then put No Facebook.

First Last

In this section DO NOT abbreviate. Awards & Metals received during Military Service. *

Name and Telephone Number of Emergency Contact *

Food Allergies. If applying as couple, which one? If none, just put None. *