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SAFMC Advisory Panel Application - Dolphin/Wahoo

The following application form is designed to help you provide the Advisory Panel Selection Committee with information on your background in fisheries (commercial, charter/headboat, recreational, conservation, and/or scientific). This information will be provided to Council members only and will be kept in strict confidence.

In completing the form, please answer all of the questions.

Applicants are encouraged to contact their Council members to discuss their interest in serving on an advisory panel. Contact information for Councils members is available on the About Us page of the Council's website at www.safmc.net

NOTE: Selected applicants must have access to a working email address and access to the Internet in order to receive materials from the Council office.

Full Name * First Last
Date of Birth * MM / DD / YYYY
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number (primary) * ### - ### - ####
Email *
LIST OF REFERENCES

Please list the name, phone, and e-mail of two references that are familiar with your fisheries experience and expertise.
Reference #1 (Name, Phone, E-mail) *
Reference #2 (Name, Phone, E-mail) *
DESCRIPTION OF FISHERIES EXPERIENCE & EXPERTISE

Please complete the questions below. List all relevant fisheries experience and expertise both past and present.
What best describes your participation in South Atlantic Fisheries (you may check more than one): *
Commercial (Full-time) Commercial (Part-time) Charter/For-Hire (Full-time) Charter/For-Hire (Part-time) Private Recreational Angler Scientific/Research Other
Please describe your experience for each of the items selected above, e.g. number of years, species fished, gear used, tournament experience, research areas of concern, etc. *
If you are currently a member of any fishermen's organizations or clubs, please list their names below.
If you have participated in the Marine Resource Education Program in the Southeast, please list the year and which workshops you attended below.
PERMITS & LICENSES

Identify permits and licenses you currently maintain from the list below:
1) State Saltwater Fishing License
2) South Atlantic Snapper-Grouper Charter/Headboat
3) Atlantic Coastal Migratory Pelagic Charter/Headboat
4) Atlantic Dolphin-Wahoo Charter/Headboat
5) Atlantic Dolphin-Wahoo Commercial
6) South Atlantic Penaeid Shrimp
7) Spanish Mackerel
8) Spiny Lobster
9) Spiny Lobster Tailing
10) South Atlantic Rock Shrimp (Carolinas Zone)
11) South Atlantic Rock Shrimp (RSLA)
12) South Atlantic Snapper-Grouper 225-LB
13) South Atlantic Unlimited Snapper Grouper
14) South Atlantic Sea Bass Pot Endorsement
15) South Atlantic Golden Tilefish Endorsement
16) South Atlantic Golden Crab
17) King Mackerel
18) South Atlantic Dealer *
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
FISHERY VIOLATION DISCLOSURE

Please complete the following information.
Have you received a federal fishery violation in the last 3 years? *
No Yes
If you answered YES to the previous question, please provide the nature and date of the violation(s) below.
By checking the box below, I consent to allow NOAA law enforcement to provide a marine fishery violation background check to be provided to the South Atlantic Fishery Management Council. *
I consent to a fishery violation background check.
ADDITIONAL INFORMATION

In the space below, please provide the Council with any additional information on your fisheries background, your interest in the fishing industries, or experience with fisheries management (including meeting attendance) which you feel would assist the Council in making its choices of new advisory panel members.

If you would like to attach a CV or any other relevant document, use the Attach a File section below to attach a document. Click the Choose File button to attach the file. The application will only accept one file in PDF format.
Additional Info
Attach a File
CERTIFICATION

By signing this application, I certify that the information I have provided is true and correct.
Type signature *
Do Not Fill This Out

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LIST OF REFERENCES

DESCRIPTION OF FISHERIES EXPERIENCE & EXPERTISE

PERMITS & LICENSES

FISHERY VIOLATION DISCLOSURE

ADDITIONAL INFORMATION

CERTIFICATION