Donor Survey
1.	Donor name :
2.	Recipient's name(s) :
3.	Recipient's Phone Number :
	( ) ( )
4.	Donor location :
5.	Donated Outdoor experience for example: hunt, fishing trip etc :
6.	Available dates :
What other costs and services is the Donor covering/providing?
7.	Round-trip flight costs for the Recipient and one parent from the city of origin?	Yes   No
8.	Will Donor provide transportation from the airport?	Yes   No
9.	Will Donor provide hunting/fishing license fee?	Yes   No
10.	Does the Donor have complete wheelchair accessibility?	Yes   No
	If not, what skills must the special Recipient have?
11.	Does the Donor have a Waiver of Liability Form?	Yes   No
12.	Taxidermy costs?	Yes   No
13.	Meat processing costs?	Yes   No
14.	Meals for the hunter, parents, handler, plus 2 or 3 others?	Yes   No
15.	Lodging for 3+ [Recipient and parent(s), spouse, or a friend]?	Yes   No
16.	Guides?	Yes   No
17.	If the special hunter can use a common hunting rifle, does the Donor have a loaner rifle? If a fishing trip, does the Donor have a loaner fishing rod and tackle?	Yes   No
18.	List other goods and services that the Donor is willing to supply? (E.g., fishing, or camouflage clothes)
Please address any other concerned issues or questions you may have about supporting a USSA event here