Release Summary

This form must be completely filled out and submitted within 14 days of fish release.
NOTE: All fields highlighted in red (as well as the Permittee's signature field) are required.
Release Information
CDFW Region where fish were released
(required) Note: look at the map to the left (or above, if on a smart phone)
(Del Norte, Humboldt counties)
(Lassen, Modoc, Shasta, Siskiyou, Tehama, and Trinity counties)
(Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Lake, Nevada, Placer, Plumas, Sacramento, San Joaquin, Sutter, Yolo, and Yuba counties)
(Alameda, Contra Costa, Lake, Marin, Mendocino, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, and Yolo counties)
(Calaveras, Fresno, Kern, Kings, Madera, Mariposa, Merced, Monterey, San Benito, San Joaquin, San Luis Obispo, Stanislaus, Tulare, and Tuolumne counties)
(Los Angeles, Orange, San Diego, Santa Barbara, and Ventura counties)
(Inyo and Mono counties)
(San Bernardino, Riverside, and Imperial counties)
Date fish were released or when the last fish died (required)
Month - Day - Year
Release location: Water body (name of lake or river)
(required)
Release location: Site (if your permit required a specific location, please indicate here)
Number of fry released
(required)
Education Information
School name
(required)
Grade level(s) of students involved
(required)
Total number of students involved in class
(required)
On field trip
(required)
Total number of hours teaching/facilitating CAEP Program
(required)
If you spent money on this project for classroom materials, equipment, or transportation, please indicate the dollar amount here.
(required)
Signature
Permittee's first name
(required)
Permittee's last name
(required)
Permittee's signature (required)
Reset
Date (required)
Month - Day - Year
Captcha

Release Summary

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Release Summary

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