Amtryke Request Forms

Inventory Update (November 2022)

In Stock: 1020
Expected in stock in early 2023: AM-10, AM-12, 1412, 1416, 1420, 1420XL
Expected in stock in spring/summer 2023: AM-12S, 1410, 1024, JT-2000, JT-2300, TP-3000

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.