Registered Maine Guide Information Form

Personal Information

First Name:			Last Name:
Address:
City:
State:
Zip:
Phone Number:

Guide License #:

Check the classification of your license:

Recreation	Fishing	Hunting	Tidewater Fishing	Sea Kayaking
Whitewater Level 1		Whitewater Level 2

Master Guide(licensed before 2003)

Master Guide(licensed after 2003)

For guides receiving Master Certification after 2003 (ten years licensed with five years of certified guiding experience):
Master Guide Recreation	Master Guide Fishing	Master Guide Hunting
Master Guide Tidewater Fishing		Master Guide Sea Kayaking

Describe your specialized skills, interests, trips you guide, equipment you have, what you hunt, what type of fishing you guide:


When are you available to Guide?
Winter Spring Summer Fall  or  From To

Do you have any special requirements that a sport should be aware of? Physical fitness requirements? Other?


Are you able to take special needs children or adults (…a sport in a wheel chair, mentally challenged children or adults with their caretakers)?


Additional Information

Name:                                    Date: