Transcription of Choctaw Nation of Oklahoma
1 Choctaw Nation of Oklahoma Oklahoma Hunting and Fishing License Box 1210 Durant, OK 74702-1210 800-522-6170 580-924-8280 Fax: 580-920-3161 Please email completed forms to Please allow 8-10 weeks processing time for receipt of your new license. Applicable fish and wildlife laws still apply to Choctaw license holders. **Applicants under the age of 16 please attach proof of residency such as a parent or guardian s driver s license or utility bill.** Please provide the following: Applicant Name: _____ Address: _____ _____ City: _____ County: _____ Zip code: _____ Phone Number: _____ Email: _____ Date of Birth: _____ (mm/dd/yyyy) Gender: _____ Social Security Number: _____ Driver s License or State ID#: _____ Hunter s Education #:_____ If you are under the age of 30, you are required to obtain a Hunter s Education certification. If you do not have access to your Hunter Education #, you will be issued an apprentice License and you will be required to have your Hunter Education Certificate within arm s reach when hunting Applicant authorizes the Choctaw Nation of Oklahoma (the Nation ) to release all information I provide in connection with this application (the Information ), to the Oklahoma department of wildlife Conservation via internet based transfer.
2 Although the Information will be sent in encrypted form, Applicant understands that encryption does NOT guarantee the safety or security of this Information and hereby forever waives all claims against the Nation that may result from the release of the Information. If Applicant is under the age of 18, please provide the name of a Parent or Guardian that agrees to the above Authorization: _____
