Name:

Phone number:

Email:

Address:

How are you or your family associated with hunting?

Why are you requesting financial assistance?

How much assistance are you requesting from Hunters Helping Hunters USA?

To whom will the assistance grant be paid?

Note: Grants will not be paid directly to any applicant.  Grants are only paid to creditors identified by the applicant and verified by Hunters Helping Hunters USA.

Please provide any supporting documentation upon request from HHHUSA.

Please provide a copy of the invoice or bill you are requesting assistance upon request.

By submitting this application I hereby authorize Hunters Helping Hunters USA to fully investigate all information I have supplied herein. I authorize Hunters Helping Hunters USA to obtain my personal financial information, verification of employment, verification of my loss and any other information Hunters Helping Hunters USA may deem necessary in order to process and investigate my application. In addition, I agree to hold harmless Hunting Helping Hunters USA, its’ employees, board of directors, and committees, from any loss or claim arising out of applying for assistance from Hunters Helping Hunters USA. I also agree to hold harmless any institution or person supplying Hunters Helping Hunters USA with information pertaining to this request. I fully understand that this application may be granted or denied at any time for any reason by Hunters Helping Hunters USA. By submitting this application and waiver I agree to the terms and conditions contained herein. I swear that the facts contained in the previous pages are true and correct to be best of my knowledge and recollection. I am also aware that swearing to false statements could make me guilty of a crime.