ANIMAL Utilization Protocol AREB Office Use Only Approval - - AUP # - - Date Day Month Year Expiry Date - - Replaces AUP # - - Day Month Year University Veterinarian’s Signature Date AREB Signature Date Prepared By: Name Email Address Principal Investigator’s Signature Date Refer to the Guide for Preparation of AUPs for assistance with completing this form (available at ) Project Title Section 1 Type of Project Research New Project Research Pilot Study Check all applicable Teaching* Ongoing Project *Attach Teaching Addendum available at . Principal Investigator Section 2 Last Name First Name Department Business Home Phone Emergency Phone Cell/Pager # Laboratory Room # Laboratory Phone Institutional Email Mailing Address Personnel and Training Section 3 List all staff personnel working under this AUP. Provide at least one person’s after hours emergency contact number. Co-PI, Tech, Hours Emergency Name Department Undergrad Student, Grad Extension Contact Number Is this work being conducted in collaboration with any other Institutions / Facilities? Yes No Please name the institution / facility.(Refer to the AREB Institutional Collaboration Policy ( ) CCAC Guidelines require that all individuals listed on the AUP take Orientation training. A print-out verifying the training must be attached to this document (contact the Training & Regulatory Coordinator, ext 22768).
ANIMAL Utilization Protocol AREB Office Use Only Approval Date - - AUP # - - Day Month Year Expiry Date - - Replaces AUP # - - Day Month Year University Veterinarian’s Signature Date AREB Signature Date Prepared By: Name Email Address Principal Investigator’s Signature Date Refer to the Guide for Preparation of AUPs for assistance with completing this form (available at ) Section 1 Project Title Type of Project Check all applicable Research New Project Research Pilot Study Teaching* Ongoing Project *Attach Teaching Addendum available at . Section 2 Principal Investigator Last Name First Name Department Business Home Phone Emergency Phone Cell/Pager # Laboratory Room # Laboratory Phone Institutional Email Mailing Address Section 3 Personnel and Training List all staff personnel working under this AUP. Provide at least one person’s after hours emergency contact number. Name Department Co-PI, Tech, Undergrad Student, Grad Extension Hours Emergency Contact Number Is this work being conducted in collaboration with any other Institutions / Facilities? Yes No Please name the institution / facility.(Refer to the AREB Institutional Collaboration Policy ( ) CCAC Guidelines require that all individuals listed on the AUP take Orientation training. A print-out verifying the training must be attached to this document (contact the Training & Regulatory Coordinator, ext 22768).
AUPForm_Nov2018_000.docx