Charles sturt university Animal Care and Ethics Committee Practical Class Fieldwork Proposal for Animal Use This application form is restricted to proposals for fieldwork (practical sessions) involving students under staff supervision, in collecting and releasing live animals (vertebrate only) as part of the requirements of a specific subject. If animals are to be retained then either form ACEC R1, ACEC W1 or ACEC T1 should be used. A separate application must be submitted for each practical class fieldwork proposal. To expedite resolution of any minor issues raised by the ACEC during consideration of your application, please mobile provide a 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 SUBJECT Description of Fieldwork Activity (animal handling, physiological experiments with rats and mice, etc.) NUMBER OF INVOLVED Internal Students External Students Where this investigation is part of a the Principal Supervisor must be nominated on this form as the student’s research project, Principal Investigator. Other participants (including students) must be listed in the appropriate section of the form. Contact Details: School or Section School or Section address Telephone
Charles sturt university Animal Care and Ethics Committee Practical Class Fieldwork Proposal for Animal Use This application form is restricted to proposals for fieldwork (practical sessions) involving students under staff supervision, in collecting and releasing live animals (vertebrate only) as part of the requirements of a specific subject. If animals are to be retained then either form ACEC R1, ACEC W1 or ACEC T1 should be used. A separate application must be submitted for each practical class fieldwork proposal. To expedite resolution of any minor issues raised by the ACEC during consideration of your application, please provide a mobile 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 Description of Fieldwork Activity (animal handling, physiological experiments with rats and mice, etc.) INVOLVED Internal Students External Students Where this investigation is part of a student’s research project, the 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. Contact Details: School or Section School or Section address Telephone SUBJECT NUMBER OF
ACEC-F1.docx