Amtryke Request Forms

IMPORTANT NOTE: Due to repercussions of the pandemic, we will not have new trykes back in stock until  late 2022. There will be a significant wait for anyone who is currently on the National Wish List and for any new requests. 
We apologize for the inconvenience and hope to find solutions to our supply chain issues, which will allow us to gift trykes sooner. If possible, we suggest pursuing Amtrykes through one of our many chapters across the nation – they may have access to outgrown, refurbished or reCycled trykes not currently available for purchase. 

The three forms below are required for all Amtryke requests.

Veterans: Please use the Veteran Amtryke Request Forms instead.

Please complete and return the forms to the AMBUCS Resource Center via email (wishlist@ambucs.org) or fax (336-852-6830).  

Required Documents, Request and WaiverRequired Documents, Assessment formRequired Documents, Selection formsRequired Documents, Hand Amtryke Selection FormRequired Documents, Foot Amtryke Selection FormRequired Documents, Hand & Foot Amtryke Selection Form

If you want to print the entire 13-page packet, use the Full Packet with Sizing Chart.

Spanish Version of the Request & Waiver Form.

Veteran’s Full Amtryke Request Packet.

Chapters, remember you can request word document versions of the forms so you can add in your contact information at the bottom. Please plan to update your forms frequently.