Award Application Form
Please fill out the form below and send it to White Seabass Forever! at the address below. The recommended donation is $20.00—the approximate cost to rear and release a cultured WSB, however we will accept an application with a minimum of $10.00. For our "Two for one" program and a special certificate, send $40.00 with your application.
First-time applicants will receive an award certificate. For subsequent applications, you will receive an attractive gold sticker that you may affix to your original certificate. The sticker will contain  information about your catch. When you fill your original certificate with stickers, simply ask for another.
We have divided California into general areas along county lines and offshore islands. Your application must contain the general area, however a more exact location (optional) will aid researchers' understanding of WSB habits and distribution.
We require your name for an application. You have the option of including your name in the WSB database, or you may choose to remain anonymous. Make your tax-deductible check payable to the Underwater Society of America and send along with your application to:
                 Freedivers’ White Seabass Conservation Project, 552 N. Victoria Ave. Ventura, Ca. 93003
                                                              Ph: 805-677-7462   Fax 805-650-3014
In addition to this application, the Project will be grateful for any additional scientific information you can supply about this catch through our Sighting link.

Name of Applicant (print the name  to appear on your award)________________________________________________
Do you want your name to appear in the official database?   yes______________  no________________
Permanent address:
______________________________________________________________________________________________

______________________________________________________________________________________________
Telephone:____________________________________________
e-mail:    ______________________________________________
Date speared: _______________________ General Location (Choose a letter or a number  from the list below)_______

From Shore—between county lines
A. Santa Cruz County
B. Monterey County
C. San Luis Obispo
D. Santa Barbara
E. Ventura
F. Los Angles
G. San Diego
Offshore Banks
H. Cortez
J. Tanner

 Off Shore Islands—since most Islands lie roughly East and West, we have arbitrarily divided them on the E/W axis. Therefore, your choices are outside (S), or inside (N).
1. San Miguel-outside
2. San Miguel-inside
3. Santa Rosa-outside
4. Santa Rosa-inside		 5. Santa Cruz-outside
6. Santa Cruz-inside7. Anacapa-outside
8. San Nicholas-outside
9. San Nicholas-inside
10. Santa Barbara
11. Catalina-outside
12. Catalina-inside
13. San Clemente-outside
14. San Clemente-inside

Specific location of catch: (OPTIONAL)______________________________________________________________________________________
________________________________________________________________________________________________

Weight: ______________________      Length (OPTIONAL): Nose to fork in tail _____________________
Was White Seabass your primary target?________  For this year, please estimate your White Seabass sightings per hours spent in the water, whether hunting or not._________________________
                                                                                             DIVER AFFIDAVIT
In order to ensure the accuracy and validity of the freediver white seabass database, I certify that the white seabass was taken by myself while freediving and that the facts presented above are true and correct.

Applicant signature: ____________________________________________________dated___________________________
                       Note: Print two copies of this application; send one to us, keep the other for your tax records

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