Lottery Application/Notification Form

Instructions

Answer questions as they relate to you. For most answers, check the boxes most applicable to you or fill in the blanks.

Please provide the following (*required)

First Name*

Last Name*

Address*

City*

State*

Zip*

Email*

Do you want notification?

1.	Would you like to receive email notification when the 2009 Online Moose Permit Lottery application is available?

	Yes
	No

2.	2. How many 2008 Maine Any-Deer Permit Lottery application do you want mailed to you?