CHARLES STURT UNIVERSITY ANIMAL CARE AND ETHICS COMMITTEE Wildlife Research Application Form Use this form for wildlife research conducted in the field (e.g., surveys) To expedite resolution of any minor issues raised by the ACEC during consideration of your application, please landline provide a telephone contact number appropriate for the duration of the relevant ACEC meeting. Alternatively you are welcome to speak to your application at the meeting. If you wish to address the meeting, please contact the ACEC’s Governance Officer on 6338 6147. Telephone Number: Office Use Only Date Received: / / ACEC Agenda Item No.: __________________ Period of Approval: / / to / / Protocol No.: __________________ Governance Officer, ACEC Date: __________________ _____________________________________ NOTE: This form be typed. must SECTION 1: ADMINISTRATION OF WHAT SPECIES WILL BE USED? THIS GIVE THE SCIENTIFIC AND COMMON NAME (AND, IF APPLICABLE, AGE, SEX AND WIEGHT). Common Name Scientific Name Age Sex Weight List any specific target species. PRINCIPAL INVESTIGATOR Where this investigation is part of a research project, their Principal Supervisor must be nominated on this form as the student’s Principal Investigator. Other participants (including students) must be listed in the appropriate section of the form. Name and Designation:
CHARLES STURT UNIVERSITY ANIMAL CARE AND ETHICS COMMITTEE Wildlife Research Application Form Use this form for wildlife research conducted in the field (e.g., surveys) To expedite resolution of any minor issues raised by the ACEC during consideration of your application, please provide a landline telephone contact number appropriate for the duration of the relevant ACEC meeting. Alternatively you are welcome to speak to your application at the meeting. If you wish to address the meeting, please contact the ACEC’s Governance Officer on 6338 6147. Telephone Number: Office Use Only Date Received: / / ACEC Agenda Item No.: __________________ Period of Approval: / / to / / Protocol No.: __________________ Governance Officer, ACEC _____________________________________ Date: __________________ NOTE: This form must be typed. SECTION 1: ADMINISTRATION GIVE THE SCIENTIFIC AND COMMON NAME (AND, IF APPLICABLE, AGE, SEX AND WIEGHT). SPECIES Common Name Scientific Name Age Sex Weight List any specific target species. Where this investigation is part of a student’s research project, their Principal Supervisor must be nominated on this form as the Principal Investigator. Other participants (including students) must be listed in the appropriate section of the form. Name and Designation: WILL THIS WHAT BE USED? OF PRINCIPAL INVESTIGATOR
ACEC-W1.docx