SAMPLE
REGULATED HUNTING DOG TRAINING AREA REPORT
Department of Environmental Protection, Wildlife Division,79 Elm St.,Hartford, CT 06106
Name of Permit Holder: WOODBURY SOUTHBURY ROD & GUN CLUB
For the Period: July 1, 2008 to June 30, 2008 Permit No: _________________________
Tag Numbers Issued: _______________ to __________________
WSRG: July 13, 2008
| DATE
PRINT PLEASE
|
HUNTER €™S FULL NAME
PRINT PLEASE |
HUNTING LICENSE NUMBER
PRINT PLEASE |
NUMBER AND NAME OF SPECIES LIBERATED
PRINT PLEASE |
NUMBER HARVESTED
PRINT PLEASE |
TAG NUMBER USED
PRINT PLEASE |
| JULY 4, 2008 | JOHN DOE | 776655 | 8 PHEASANTS | 3 | 84303-1 -2 -3 |
| JULY 4, 2008 | JOHN DOE | 776655 | 3 CHUKARS | 2 | 84303-4 -5 |
| JULY 4, 2008 | ED SMITH | 556677 | 3 PHEASANTS | 3 | 84303-6 -7 -8 |