REBATE FORM
First Name
*
Last Name
*
Mailing Address
*
Zip Code
*
State
*
City
*
Email
*
Phone #
Date Ammunition Purchased
*
Name of store
*
Upload a copy of your receipt for qualifying copper ammunition.
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload photo of ammunition box showing product name and caliber (often on the side of the box)
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Q.1 Before learning about this program, did you know that using lead bullets for big game hunting can cause unintended lead poisoning of eagles and other wildlife?
Yes
No
Q.2 Do you currently use copper bullets for big game hunting in Alaska?
Yes-I always use copper
Yes-I occasionally use copper
No
Alaska Chapter of Backcountry Hunters and Anglers
I’d like to learn more about the Alaska Chapter of Backcountry Hunters and Anglers.
Alaska Falconers Association
I’d like to learn more about the Alaska Falconers Association.
I confirm I am a licensed hunter in Alaska with a valid Alaskan mailing address.
