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 OnlyDate Received: / / / / ACEC Agenda Item No.: / ______
Period of Approval: / / / to / / / Protocol No.: / ______
Governance Officer, ACEC ______/ Date: / ______
NOTE: This form must be typed.
SECTION 1: ADMINISTRATION
1. title of project:
2. what species of animal will be used? (For surveys this may be all vertebrates). GIVE THE SCIENTIFIC AND COMMON NAME (AND, IF APPLICABLE, AGE, SEX AND WIEGHT).
SPECIES / Common Name / Scientific Name / Age / Sex / WeightList any specific target species.
3. principal investigatOR
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:
School / Section:
School Section Address:
Contact Details:
TelephoneBetween hours
After hours
Email Address
4. DATES FOR APPROVAL (Use DD/MM/YY format):
From: To:
For ongoing work where methodology does not change, you may apply for an approval period of up to three (3) years after the proposed commencement date, as the ACEC can approve ongoing projects for up to 3 years subject to receipt of annual reports (ACEC R2). Please note that Annual Review Forms are required under the Australian Code for the Care and Use of Animals for Scientific Purposes (2.4.34)
5. description of relationship of principal investigator with the institution
(Employee, Collaborative Research, Independent of CSU, etc.)
6. A. HAS AN EXTERNAL ORGANISATION AGREED TO SUPPORT THIS APPLICATION, OR HAS AN APPLICATION FOR EXTERNAL SUPPORT BEEN LODGED?
Choose one: Yes o
No o
If YES, provide details (i.e., name of the organisation and date of application, and whether the application has, to date, been successful.)
B. IF A FUNDING APPLICATION IS NOT SUCCESSFUL, WILL THE PROJECT STILL PROCEED?
Choose one: Yes o
No o
7. a. is this application for a new project?
Choose one: Yes o
No o
B. IS THIS APPLICATION FOR A PROJECT WHICH BEEN, PREVIOUSLY OR SIMULTANEOUSLY, SUBMITTED TO THIS OR ANOTHER ETHICS COMMITTEE?
Choose one: Yes o
No o
If YES, provide reasons for resubmission or simultaneous submission, and the name of the AEC or AECs and approval numbers where appropriate.
C. IS THIS APPLICATION FOR A SIGNIFICANTLY REVISED CURRENT PROTOCOL?
Choose one: Yes o
No o
If YES, quote the approval number, species and number of animals used to date.
8. where is the research work to take place? DESCRIBE IN RELATION TO THE NEAREST TOWN.
9. HAVE the relevant licences been obtained from the national parks and wildlife service (npws), or other authorities?
Choose one: Yes o
No o
Permit Type and Number:
Dates over which Permit is Valid:
10. HAVE ANY OF THE PEOPLE PARTICIPATING IN THE PROJECT HAD ANY ANIMAL RESEARCH AUTHORITY OR ANIMAL SUPPLIER’S LICENCE CANCELLED?
Choose one: Yes o
No o
If YES, please provide details including the name of the person, the date on which the authority or licence was cancelled, who cancelled the authority and the reason for cancellation:
Name of Staff Member / Date Authority / Licence Cancelled / Name of Cancelling Body / Reason for Cancellation of Authority / LicenceSECTION 2: JUSTIFICATION FOR ANIMAL USE
Aims of the project in lay terms
The Code of Practice states that “Animal experiments may only be performed when the scientific merit justifies the use of animals”.
Your answer is crucial for the assessment of scientific merit and the necessity of animal use. Use lay terms; terms that will be understood by a member of the Committee without a scientific background.
11. describe the aims of the project in lay terms that a person without a scientific background will understand. specify what you hope to achieve. please give the background to this project, WITH A SUPPORTING LIST OF key references.
12. give a brief description of the methods used.
13. If the project repeats previously-reported experiments, give the reasons for the experiments being repeated.
Reasons for animal use
14. if animals are to be captured, explain WHY this is necessary. what alternatives to capturing animals have been considered and why are this inappropriate?
15. WHAT additional PRECAUTIONS WILL BE TAKEN IF fieldwork is carried out during the breediNg season, or if lactating individuals or animals with dependent young are captured?
SECTION 3: ETHICAL CONSIDERATIONS
AN ASSESSMENT OF THE IMPACT ON ANIMAL WELL-BEING
sequence of events
16. give details (sequentially) on what happens to the animals(s) from the time they are captured until the time they are released.
Aspects may include handling, housing, etc., as well as specific procedures. Refer to the CHECKLIST at the end of this application form to ensure all details have been considered and refer to published Standard Operating Procedures where appropriate.
Please list any Standard Operating Procedures which are to be used – please refer to the ACEC Register of Standard Operating Procedures on the ACEC website for a complete list of Standard Operating Procedures (SOPs) already approved by the Animal Care and Ethics Committee. If you are submitting a new Standard Operating Procedure for approval by the Committee, please insert “None- New for Approval” under “SOP Number”.
Please also consult the ARRP Guideline 10, “Wildlife Survey” guidelines on the ACEC website.
SOP Number / SOP NameA flow chart or Sequence of Events table may assist in making this information clear.
If any media-related activities arise from this research (for example, photo shoots for newspaper / magazine / journal features or filming for documentaries or television news features), you will need to advise the Animal Care and Ethics Committee and submit photographs or filming to the Committee as part of the animal use associated with this project.
impact
17. will the methods described in the animal care guidelines for wildlife surveys by nsw department of primary industries (DPI) be followed to minimise on animals?
Choose one: Yes o
No o
If NO, give a detailed explanation.
18. how many traps will be set and over what period of time?
19. WHAT TRAPS WILL BE USED?
If using Mist Nets, please provide details of experience and training in use. If Pitfall Traps are to be used, the Guidelines for the Use of Pitfall Traps by NSW DPI must be followed.
20. how often and at what times will traps be checked and / or cleared?
21. describe any other methods to be used for capture.
22. what precautions will be taken in the event of inclement weather?
23. will samples be taken?
(Milk, Scales, etc.)
Choose one: Yes o
No o
If YES, give details.
24. how will animals be handled or restrained?
25. is transportation necessary?
Choose one: Yes o
No o
If YES, describe how animals will be transported, over what period of time and what precautions will be taken against cold / heat / stress, etc.,
26. how will animals be individually identified?
27. what, if any, adverse effects will there be on the animals in relation to all the procedures you will carry out?
28. if invasive methods are to be used, how Will pain / distress be minimised?
29. will any radio-tracking collars or other radio-tracking equipment be used?
Choose one: Yes o
No o
A. If YES, describe what equipment will be used on the animal, how it will be attached, how much the equipment weighs and the impact on the animal.
B. How will the equipment be retrieved?
animal monitoring
30. who will monitor the animals?
Name / Qualifications / Experience with Species Used31. how will the animals be monitored during capture, handling and post-release?
32. will animals be housed?
If YES, justify why animals need to be housed, and be not be released immediately, and answer questions A – C below.
A. How will the animals be housed (including whether housed separately or not)?
B. What will be the duration of housing?
C. What will the animals be fed, and how often, whilst housed?
emergencies
33. identify possible emergencies which may arise during this project
(animal injured in a trap, bushfire, hailstorm, etc.)
34. list the procedures you have in place to deal with these emergencies, including emergency contacts in the field
(contact number of local veterinary surgeon, etc.)
If the animal or animals need to be euthanased, please refer to question 40 below.
re-use
35. does this project involve the use of any animals or fauna survey sites that have Been the subject of previous research?
Choose one: Yes o
No o
If YES, what has previously been done to these animals? Include the project name(s) and identification number(s).
fate of animals
36. what will happen to THE animals at the completion of the project?
37. will voucher specimens be taken?
Choose one: Yes o
No o
If YES, please answer questions A – C below.
A. Provide justification for the taking and the number of voucher specimens.
B. Where will the voucher specimens be lodged?
C. Will Collection of Voucher Specimens by the Department of Primary Industries be followed?
Choose one: Yes o
No o
If NO, provide a detailed explanation.
38. WHAT WIL HAPPEN TO ANY NON-TARGET SPECIES CAPTURED DURING THE COURSE OF THIS PROJECT?
(feral animals, carp, etc.)
39. if animals are to be euthanased:
A. What method of euthanasia will be used?
B. Where will euthanasia be carried out?
C. Who will do it, and what is their experience in the technique to be employed?
technical
40. list the qualifications and experience of all personnel who will be participating in the animal components of the project. detail whether the experience is with the species being used, as well as wether the experience is with the procedures being undertaken.
Please tell the Committee what experience the person has relevant to the procedure to be performed, and how many years’ experience in that field that nominee has.
Name & Qualifications / Experience in procedures to be undertaken and the species being used.If no experience, describe how relevant experience will be obtained / Contact Details:
- work phone no.
- home phone no.
- email address
Principal Investigator
Associate Investigator(s)
Other participants
SECTION 4: DECLARATION OF RESPONSIBILITIES
DECLARATION BY THE PRINCIPAL INVESTIGATOR
I certify that the use of animals in this project will conform with the NSW legislation and the general principles of the NHMRC / CSIRO / AAC Australian Code for the Care and Use of Animals for Scientific Purposes. I accept responsibility for the conduct of all procedures detailed in this application and for the supervision of all personnel delegated to perform any such procedures.
I confirm that all personnel have read this application and have agreed to comply with procedures described and any conditions imposed by the ACEC.
I confirm that I have taken into account potential hazards to staff working with animals in this project, and have ensured that appropriate safety measures have been implemented.
Principal Investigator:______(Signature) / Date: ______
(Print Name)
Declaration by Head of School / Section (as applicable)
I have read this application and am satisfied that the use of animals is justified on scientific, educational or diagnostic grounds.
Head of School / Section:______(Signature) / Date:______
(Print Name)
School / Section:______
Submit this form to: The Governance Officer, Animal Care and Ethics Committee
Office of Governance and Corporate Affairs
CSU in Bathurst
Building 1205
Email:
CHECKLIST
² What is happening to the animals?
² What will be the effects?
² How will the effects be minimised?
Anaesthesia / Euthanasia / Toxicology Fasting / Method / Substance
Induction – drug, dose, route / Location (where procedure will be performed) / Volume
Route
Maintenance – drug, dose, route / Expertise of personnel / Frequency of treatments /
Methods of monitoring anaesthesia and recovery / Total number per animal
Local and systemic effects
Additional support during anaesthesia and recovery (e.g., heat, intravenous fluids) / Genetic Manipulation
Methods
Potential effects / Anaesthesia or analgesia
Restraint
Animal monitoring (methods and
Location of induction and recovery areas / frequency
Endpoint / duration
Housing / Tumour / neoplasia induction
Behaviour Modification / Location / Method
Stimulus (type, duration, frequency) / Group housing (stocking rates, sexes) / Site
Endpoint
Isolation / Animal monitoring (methods,
Blood / Body Fluid Collection / Shelter / frequency
Volume / Bedding
Route / Hiding areas / Transport
Frequency / Environmental enrichment / Type
Anaesthesia or analgesia / Duration held / Duration
Restraint / Conditioning period / Confinement
Animal monitoring (methods & frequency) / Numbers of animals
Air conditioning
In-vitro Studies
Diet / Water Modifications / Source of animals / Teaching
Type / Duration held / Source of animals
Amount / Euthanasia / Housing
Effects / Duration held
Measurement of Intake / Surgery / Method of disposal
Animal Monitoring / Anaesthesia
Location of pre-operative preparation area / Wildlife Studies
Location
Drug Treatments / Surgical procedure (site, technique) / Methods
Capture methods
Substance
Volume / Sterile technique (instruments, drapes, surgeon) / Handling methods
Handling / restraint
Route
Frequency / total number per animal / Location of and housing in post-operative recovery area
Post-operative management / Housing / holding
Monitoring
Release
Local and systemic effects
Anaesthesia or analgesia / Post-operative monitoring (methods, frequency, duration) / Effects on population
Possible side effects
Restraint / Use of analgesics (type, dose, route, frequency, means of determining necessity for use)
Expertise
ACEC W1 Page 4