Application For Fish Resource Permit Form - Alaska Department Of Fish And Game

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STATE OF ALASKA
DEPARTMENT OF FISH AND GAME
APPLICATION
for
FISH RESOURCE PERMIT to take, possess, hold alive, or tag, FISH AND THEIR EGGS (except
goldfish and decorative tropical fish) FOR SCIENTIFIC OR EDUCATIONAL PURPOSES.
I,______________________________, of _______________________________________
(name)
(organization or institute)
_________________________________________________________________________
(mailing address)
(city, state, zip code)
___________________
___________________
______________________________
(telephone number)
(fax number)
(email address)
under contract to: ______________________________________________, hereby make
(name and address of contractual organization or institute)
application for a permit to: ____________________________________________________
)
(specify: take; and possess, or sample & release, or tag & release, or sacrifice, etc.
the following species:
SPECIES - COMMON NAMES
NO.
SPECIES-COMMON NAMES
NO.
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
______________________________ _____ _____________________________ _____
during the period ________________________ to ___________________________ 20___
I wish to obtain the above by means of__________________________________________
(specify type of traps, seines, gillnets, dip nets, etc.)
from _____________________________________________________________________
(be specific to location(s), i.e., X River at latitude and longitude, or ESE of Pt. Barrow, or on Kodiak Island, etc.)
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