License Application Form - azgfd
Arizona Game and Fish Department 5000 W. Carefree Hwy. Phoenix, AZ 85086 azgfd.gov
HIGH ACHIEVEMENT SCOUT LICENSE APPLICATION FEE: $5.00
The Department may issue a High Achievement Scout License to an individual who is a bona-fide Arizona resident and is either: a member of the Boy Scouts United States of America, who has attained the rank of Eagle Scout; or a member of the Girl Scouts of the United States of America, who has attained the Gold Award. This license is a reduced fee, youth class F combination general hunting and fishing license that grants all of the hunting and fishing privileges of the class F combination hunting and fishing license. Required documentation: For an applicant who is a member of the Boy Scouts of the United States of America, any one of the following original documents; A certification letter from the Boy Scouts of the United States of America stating that the applicant has attained the rank of Eagle Scout, A Boy Scouts of the United States of America Eagle Scout Award Certificate, or A Boy Scouts of the United States of America Eagle Scout wallet card. For an applicant who is a member of the Girl Scouts of the United States of America, any one of the following original documents; A certification letter from the Girl Scouts of the United States of America stating that the applicant has completed the award, A Girl Scouts of the United States of America Gold Award Certificate, or A Girl Scouts Gold Award Certificate from the local council. Copies of original certification must accompany each application. If original documentation is presented at a Department office, copies will be made to keep on file and customer will retain original documentation. **Social Security Number is voluntary-to be used for Sportsman’s Database Only
Name
Date of Birth
Phone
Address
City
State
Zip
Mailing Address (if different than above)
City
State
Zip
Department ID/SSN**
Email Hair
Yrs of Residency
Gender
Height
Weight
Applicant Signature*
Eyes
Date
*DO NOT SIGN THIS APPLICATION until you are in the presence of a Department employee or a notary public. This application must be notarized if it is not presented in person. I do hereby certify that on (date) _________ (applicant name)_____________________ Personally appeared before me and made the above declaration. In witness whereof, I have hereunto set my hand and affixed my official seal this (date)____________
Notary Public in and of the county of __________, State of Arizona. My commission expires_______.
(seal)
ARIZONA GAME AND FISH DEPARTMENT USE ONLY Date Received
Phx
SSD_SAM 2.6 K_Form 306_Revised 02/07/2017
Region
Approved
Denied
HIGH ACHIEVEMENT SCOUT LICENSE APPLICATION FEE: $5.00
The Department may issue a High Achievement Scout License to an individual who is a bona-fide Arizona resident and is either: a member of the Boy Scouts United States of America, who has attained the rank of Eagle Scout; or a member of the Girl Scouts of the United States of America, who has attained the Gold Award. This license is a reduced fee, youth class F combination general hunting and fishing license that grants all of the hunting and fishing privileges of the class F combination hunting and fishing license. Required documentation: For an applicant who is a member of the Boy Scouts of the United States of America, any one of the following original documents; A certification letter from the Boy Scouts of the United States of America stating that the applicant has attained the rank of Eagle Scout, A Boy Scouts of the United States of America Eagle Scout Award Certificate, or A Boy Scouts of the United States of America Eagle Scout wallet card. For an applicant who is a member of the Girl Scouts of the United States of America, any one of the following original documents; A certification letter from the Girl Scouts of the United States of America stating that the applicant has completed the award, A Girl Scouts of the United States of America Gold Award Certificate, or A Girl Scouts Gold Award Certificate from the local council. Copies of original certification must accompany each application. If original documentation is presented at a Department office, copies will be made to keep on file and customer will retain original documentation. **Social Security Number is voluntary-to be used for Sportsman’s Database Only
Name
Date of Birth
Phone
Address
City
State
Zip
Mailing Address (if different than above)
City
State
Zip
Department ID/SSN**
Email Hair
Yrs of Residency
Gender
Height
Weight
Applicant Signature*
Eyes
Date
*DO NOT SIGN THIS APPLICATION until you are in the presence of a Department employee or a notary public. This application must be notarized if it is not presented in person. I do hereby certify that on (date) _________ (applicant name)_____________________ Personally appeared before me and made the above declaration. In witness whereof, I have hereunto set my hand and affixed my official seal this (date)____________
Notary Public in and of the county of __________, State of Arizona. My commission expires_______.
(seal)
ARIZONA GAME AND FISH DEPARTMENT USE ONLY Date Received
Phx
SSD_SAM 2.6 K_Form 306_Revised 02/07/2017
Region
Approved
Denied
