FWC "Big Catch Application" Page

Florida Fish and Wildlife Conservation Commission

Note: An Adobe Acrobat PDF file is available that will print better than this on screen version, if your prefer.

OFFICIAL APPLICATION - BIG CATCH PROGRAM

NAME: ______________________________________     DATE OF BIRTH: __/__/____



ADDRESS: ___________________________________     TELEPHONE: (___) ___-____



CITY, STATE, AND ZIP CODE: _______________________________________________



SOCIAL SECURITY NUMBER: ___-__-____



DATE FISH WAS CAUGHT: __/__/__  WHERE FISH WAS CAUGHT: ___________________



COUNTY IN WHICH FISH WAS CAUGHT: _________________________________________TIME OF CATCH: __:__       [ ] AM     [ ] PM



FISH METHOD USED TO CATCH FISH:



[ ] Rod and Reel with Artificial Lure     Lure Used: _____________________

[ ] Rod and Reel With Natural Bait        Natural Bait Used: _____________

[ ] Cane Pole With Natural Bait           Natural Bait Used: _____________

[ ] Fly Rod and Reel with Artificial Fly  Fly Used: ______________________

[ ] Other Fishing Method (Describe): _____________________________________



                IDENTIFICATION AND WEIGHT/LENGTH OF FISH

*SEE BACK OF FORM FOR ELIGIBLE FISH SPECIES AND MINIMUM QUALIFYING WEIGHTS

AND LENGTHS.



SPECIES: _______________  WEIGHT: ________________  GIRTH: _______________



LENGTH: ________________  WAS FISH RELEASED?     Yes ______  No __________



TYPE OF AWARD:



      [ ] ANGLER RECOGNITION     [ ] YOUTH AWARD



      [ ] SPECIALIST AWARD       [ ] MASTER AWARD      [ ] ELITE AWARD



     The fish described in the application was legally caught in the state 

of Florida, by myself, and the above information is true and correct.  

The Florida Fish and Wildlife Conservation Commission may use this information 

for research, informational and other public purposes.



Applicant's Signature: ___________________________________________________



Fishing License Number: __________________________________________________



IF EXEMPT, CHECK ONE: 



      [ ] Younger than 16, [ ] Older than 65, [ ] Permanently disabled,



      [ ] Used Cane Pole in County of Residence, [ ] Military Home on Leave,



      [ ] Other:

Witness' Signature: ______________________________________________________



MAIL COMPLETED APPLICATION TO:Florida Fish and Wildlife Conservation Commission

Big Catch Program

620 South Meridian Street

Tallahassee, FL 32399-1600

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