STATE OF ALASKA



STATE OF ALASKA

DEPARTMENT OF FISH AND GAME

APPLICATION

for

EDUCATIONAL PERMIT

PERMIT to possess game parts for EDUCATIONAL PURPOSES.

|I, |      |of |      |

| |(name) | |(organization or institution) |

|      |

| (address) |

|      | |      |

|(telephone number) |(fax number) |

|      | |      |

| (cell phone number) |(e-mail address) |

|hereby make application for a permit to receive from the Alaska Department of Fish and Game and possess indefinitely the following items (attach |

|additional sheets if necessary): |

| | |

|Species (Common or Scientific Name) |Item Description (hide, skull, etc.) |Number |

|      | |      | |      | |

|      | |      | |      | |

|      | |      | |      | |

|      | |      | |      | |

|      | |      | |      | |

| |

|Please describe the educational program or activities for which these items are being requested (attach additional sheets if necessary): |

|      |

|I certify that all statements entered on this application are true and that I will abide by all conditions and restrictions of a permit if issued, |

| | | |

|(Signature) | |(Date) |

|Completed applications should be submitted to: |

|ADF&G, Division of Wildlife Conservation ADF&G, Division of Wildlife Conservation |

|333 Raspberry Rd. or 1300 College Rd. |

|Anchorage, AK 99518 Fairbanks, AK 99701 |

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