Fish Resourse Permit Form - Alaska Department Of Fish And Game

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STATE OF ALASKA
DEPARTMENT OF FISH AND GAME
CLASSROOM INCUBATION PROJECT
PROPAGATION APPLICATION
for
FISH RESOURCE PERMIT for scientific or educational purposes to take, transport, possess, hold alive, FISH
AND THEIR EGGS (except gold fish and decorative tropical fish) for a CLASSROOM INCUBATION
PROJECT. The amount that can be held is less than or equal to 500 eggs or one spawning pair .
___________________________________ _______________________________________
(Name of Instructor)
(Organization or School)
______________________________________________________________________________
(Mailing Address)
(City, State, Zip Code)
_____________________ (email)
Telephone: ______________ (work)
_______________(fax)
______________ (home)
School District: _____________________________________________________________
***A WRITTEN OPERATIONAL OR STUDY PLAN IDENTIFYING THE PURPOSE AND THE NEED
FOR THE CLASSROOM INCUBATION PROJECT, RESEARCH OBJECTIVES, PROCEDURES, AND AN
EXPLANATION OF BENEFITS THAT MAY ACCRUE TO THE STUDENTS MUST BE ATTACHED.***
I would like to conduct a classroom incubation project using the following:
(check the appropriate box)
chum (dog) salmon
[
]
pink (humpy) salmon
[
]
coho (silver) salmon
[
]
I would like to incubate/rear a total of ____________ (amount requested).
The
maximum amounts for this permit are less than or equal to 500 eggs or one
spawning pair.
Life stage requested: (check appropriate box)
[
]
Spawning adult (maximum one spawning pair)
[
]
Green eggs (newly fertilized--later summer through late fall)
[
]
Eyed eggs (eyes visible in egg--available early winter to mid winter)
[
]
Alevin (newly hatched yolk-sac fry--generally not transportable)
[
]
Emergent fry (early free swimming juvenile salmonid--available spring)
I wish to obtain the above by means of: (check appropriate box)
[
]
Directly from hatchery.
Name of hatchery: _____________________________
Approximate date of transport: _______________ to ________________,19___
[
]
production egg-take
[
]
incubator
[
]
Remote location.
Name of stream, river, or lake: ______________________
Approximate date of transport: _______________ to _______________, 19___
Method: (check appropriate box)
[
] beach seine
[
] gillnet
[
] dipnet
[
] rod and reel
[
]
other technique (please explain the procedures planned for the egg
take):

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