VERMONT FISH AND WILDLIFE DEPARTMENT

103 SOUTH MAIN STREET - 10 SOUTH - WATERBURY, VERMONT 05671-0501

 

Application for a Fishing Tournament/Derby Permit

(To avoid a delay in your permit being issued and possible return of this form, please make   sure the requested information is legible, accurate and complete!)

 

Name of Organization:_____________________________________________________

 

Contact Person (include mailing address and e-mail address):

_______________________________

_______________________________________________________________________

 

Day and Evening Telephone Numbers:                                                                                 

 

Dates and Times of Tournament:____________________________________________

 

Town, County and Water Body Where Event Is to Be held:

_________________________________________________

_________________________________________________

 

Location of Headquarters:__________________________________________________

 

Location of Check Stations:_________________________________________________

 

Fish Species Involved:______________________________________________________

 

Number of Anglers Expected:________________________________________________

 

(The Fish and Wildlife Department encourages events with catch and release features.)

 

  PLEASE NOTE

Application must be received 30 (thirty) days before the scheduled tournament.

Please forward completed application form to address above and enclose a $50.00 fee; make check payable to Vermont Fish and Wildlife Department.  Do not send cash.

Note: There is no fee for a tournament which 1) limits the entrants to people below 15 years of age; or 2) is part of a Special Olympics Program.

If you plan to make special use of a Department access facility, you may need specific authorization from the Department in addition to the tournament permit.   Please contact the district office covering your tournament location – refer to the information packet included with your application(s).

To avoid tournament scheduling conflicts, please contact Norm White, President of the Vermont Bass Federation (Phone: (802) 223-7793 and e-mail: nsk1@adelphia.net).