"New or Re-elected Advisory Committee Member Form" - Alaska

New or Re-elected Advisory Committee Member Form is a legal document that was released by the Alaska Department of Fish and Game - a government authority operating within Alaska.

Form Details:

  • Released on September 1, 2014;
  • The latest edition currently provided by the Alaska Department of Fish and Game;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Alaska Department of Fish and Game.

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Download "New or Re-elected Advisory Committee Member Form" - Alaska

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NEW OR RE-ELECTED ADVISORY COMMITTEE
MEMBER FORM
Alaska Department of Fish and Game, Boards Support Section
ADVISORY COMMITTEE_____________________________________________________
DATE OF ELECTION: _________________ FOR A _____ YEAR TERM. EXPIRES 6/_____
Advisory Committee member you replaced: _________________________________________
SEAT: Designated _______________ Undesignated _____________ Alternate ___________
For OFFICER ELECTIONS please check your office title.
Chairman __________ Vice-chairman ___________ Secretary ___________
It is important to have your complete mailing address in order to receive information from Boards Support
Section regarding Board of Fisheries, and Board of Game materials.
Male
NAME: ______________________________________________________________
Female
ADDRESS: ___________________________CITY__________________, AK, ZIP ____________
PHONE:
Home ____________________ Work ___________________ FAX ____________________________
Email Address: __________________________________________________
Please check activities 1-12 in which you participate:
Please check the box of your race.
1. Trapping
7. Guiding
Alaskan Native
2. Sport Fishing
8. Processing
American Indian
3. Subsistence
9. Personal Use
Asian/Pacific Islander
4. Hunting
10. Outdoorsperson
African-American
5. Commercial Fishing
11. Assoc./Corp.
Hispanic
6. Photography
12. Conservationist
Caucasian
Name/s of related organization/s and corporations to which you belong ___________________________________
______________________________________________________________________________
______________________________________________________________________________
Because the Alaska Department of Fish and Game receives federal funding, all of its public programs and
activities are operated free from discrimination on the basis of race, color, national origin, age, or handicap.
O.E.O, U.S. Department of the Interior, Washington, D.C. 20240
Signature ____________________________________________________ Date __________
THIS FORM MUST BE SUBMITTED TO YOUR REGIONAL COORDINATOR AT THE BOARDS SUPPORT
SECTION WITHIN 30 DAYS OF THE ELECTION OR YOUR ELECTION TO THE COMMITTEE MAY BE
VOIDED. SEND THIS FORM TO THE FOLLOWING ADDRESS: Alaska Department of Fish and Game, Boards
Support Office, P.O. Box 115526, Juneau, Alaska 99811-5526. For more information, contact 465-4110.
Updated 9/2014
NEW OR RE-ELECTED ADVISORY COMMITTEE
MEMBER FORM
Alaska Department of Fish and Game, Boards Support Section
ADVISORY COMMITTEE_____________________________________________________
DATE OF ELECTION: _________________ FOR A _____ YEAR TERM. EXPIRES 6/_____
Advisory Committee member you replaced: _________________________________________
SEAT: Designated _______________ Undesignated _____________ Alternate ___________
For OFFICER ELECTIONS please check your office title.
Chairman __________ Vice-chairman ___________ Secretary ___________
It is important to have your complete mailing address in order to receive information from Boards Support
Section regarding Board of Fisheries, and Board of Game materials.
Male
NAME: ______________________________________________________________
Female
ADDRESS: ___________________________CITY__________________, AK, ZIP ____________
PHONE:
Home ____________________ Work ___________________ FAX ____________________________
Email Address: __________________________________________________
Please check activities 1-12 in which you participate:
Please check the box of your race.
1. Trapping
7. Guiding
Alaskan Native
2. Sport Fishing
8. Processing
American Indian
3. Subsistence
9. Personal Use
Asian/Pacific Islander
4. Hunting
10. Outdoorsperson
African-American
5. Commercial Fishing
11. Assoc./Corp.
Hispanic
6. Photography
12. Conservationist
Caucasian
Name/s of related organization/s and corporations to which you belong ___________________________________
______________________________________________________________________________
______________________________________________________________________________
Because the Alaska Department of Fish and Game receives federal funding, all of its public programs and
activities are operated free from discrimination on the basis of race, color, national origin, age, or handicap.
O.E.O, U.S. Department of the Interior, Washington, D.C. 20240
Signature ____________________________________________________ Date __________
THIS FORM MUST BE SUBMITTED TO YOUR REGIONAL COORDINATOR AT THE BOARDS SUPPORT
SECTION WITHIN 30 DAYS OF THE ELECTION OR YOUR ELECTION TO THE COMMITTEE MAY BE
VOIDED. SEND THIS FORM TO THE FOLLOWING ADDRESS: Alaska Department of Fish and Game, Boards
Support Office, P.O. Box 115526, Juneau, Alaska 99811-5526. For more information, contact 465-4110.
Updated 9/2014