Please provide the following information for each of the falconry raptors in your possession at the present time:
Species Band Number Band Type and Color
1.___________________________________________________________________________________ 2.________________________________________________________________________
3.________________________________________________________________________
Age Sex Date of Acquisition Source of Birds
1.________________________________________________________________________
2.________________________________________________________________________
3.________________________________________________________________________
Have you ever been cited for any
infraction of the Federal Migratory Bird Treaty Act, Endangered
Species Act, CITES
or a State Fish and Wildlife
law? __________Yes
__________No
APPLICANT’S CERTIFICATION
Thereby certify that I have read and am familiar with the West Virginia State falconry regulations, and I further certify that under penalty of perjury that information provided on this form is true to the best of my knowledge and belief, and that I have not failed to meet child support obligations as defined in WV Code 48-5A, and that I realize that making a false statement may result in loss of my license. I understand that any false statement in this application may subject me to the criminal penalties outlined in State and Federal law.
APPLICANT’S SIGNATURE: DATE:________________
If under eighteen years of age, a signature of your parent/guardian is also required.
Parent/guardian Signature:____________________________________Date_______________________
SPONSOR’S CERTIFICATION: I hereby certify that I am a master
or general falconer with permit number ________________and that I
have agreed to sponsor the above-named individual as an
apprentice falconer.
_____________________________________________________________________________________
Printed name of sponsor Phone number
_____________________________________________________________________________________ Signature of Sponsor Date
You will receive a permit for falconry from the State of West Virginia upon proof of satisfactory written examination completion (exams will be given at Division District Offices and Elkins Operations Center) and an approved facilities inspection sheet. A federal falconry permit is also required. To obtain this permit, you must contact the U.S. Fish & Wildlife Service, Migratory Bird Permit Office, Post Office Box 779, Hadley, MA 01035-0779 or call: (413) 253-8642. Their fee is $25. You will have to provide a copy of your WV permit.