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ANIMAL CARE AND ETHICS COMMITTEE
Collaborative Research Application
Office of Research
This form may be used for animal research projects or teaching activities where:
• Animals are housed in the facilities and cared for by animal care or research staff of more than one
accredited research establishment, either simultaneously or at different times during the project.
• Projects carried out by a formally constituted collaborative research group, from different
organisations/institutions, such as a cooperative research centre.
• Projects carried out under informal collaborative arrangements at more than one institution.
Information:
If you have an ethics approval from another institution eg another University, then use this form to apply for review and
ratification by the ACEC of that approval.
You will be required to complete a full application form to attach with this application in cases where elements of a
project are not be covered by another Institution’s approval.
To submit:
Complete this form.
Attach a copy of the external ethics approval
Attach any supporting documents (i.e. AEC approval, original application, and literature review or reference list)
in a single file.
Email to Office of Research - [email protected]
ATTENTION MAC USERS: This form will be corrupted if opened in Preview.
Project Name/Teaching Unit:
External Organisation Name:
External researcher Name:
Qualification:
Degree undertaken:
School/Centre:
Email: Phone:
SECTION A: PROJECT DETAILS
Office of Research
Has this research been approved by another Animal Ethics Committee? YES NO
If YES, complete SECTION B. AEC Name (if applicable):
AEC contact name:
Address:
Email: Phone:
Ethics Approval Number:
Date of Approval: Period of Approval:
A copy of the ethics application and ethics approval must be attached to this form.
SECTION B: ANIMAL ETHICS COMMITTEE
SECTION C: SOUTHERN CROSS UNIVERSITY
Are researchers from SCU involved in this project? YES NO
If YES, complete SECTION C.
SCU Principal Investigator Name:
Qualification/Status:
Degree being undertaken (if applicable):
School/Centre:
Email: Phone:
Describe your involvement in this project:
Office of Research
SECTION D: SCU PARTICIPATION
Will SCU staff and/or students be participants in this research?
YES NO
If NO, move to SECTION G, If YES, complete SECTION D.
Describe where the research or teaching is to be conducted, eg School of Environment, Science and
Engineering, National Marine Science Centre or other location:
Describe the method of the research or teaching, eg field observation, baiting and trapping, laboratory research:
Has the Head of School and/or Director of Research been informed about this research/activity?
YES NO
Have they approved the conduct of this research/activity at SCU?
YES NO
If NO, explain why the the research cannot be conducted at SCU:
Commencement date: Completion date/duration of research:
SECTION E: RESEARCH/ACTIVITY SUMMARY
Provide a brief summary of the research or activity as it applies to the SCU component:
SECTION F: INTELLECTUAL PROPERTY
Does the research/activity involve any contracts including confidentiality agreements?
YES NO
If YES, detail any particular conditions that might have ethical implications for the research (e.g access to
data, publications etc). Attach a copy of the contract to this application
Office of Research
SECTION G: DECLARATIONS
(i) Principal Investigator Declaration:
As the Principal Investigator, I declare that the information I have given is true and that my research does
not contravene the Code of Practice for the care and use of animals in scientific research or the Animal
Research Act 1985.
I declare that I will notify the SCU ACEC of an ethically relevant variation to this research.
In signing this declaration, I guarantee that this form has been distributed to each member of the research
team and they have agreed to abide by the principles and processes of the research as outlined in this
application.
Name Principal Investigator:
Signature: Date:
Head of School/Director of Research declaration: If applicable, and if the research is being conducted with SCU participants in a particular School/Centre.
Name Head of School/SRC:
Signature: Date:
CHECK LIST
To ensure minimum delay in the consideration of your application, please indicate that you have supplied
the following:
I have attached/completed the following:
• A copy of external ethics application. YES N/A
• A copy of external ethics approval. YES N/A
• Consent form/information letter(s), if necessary. YES N/A
• Literature and Reference List. YES N/A
• Permission from SCU. YES N/A
• Signed declaration. YES N/A
• Submitted to [email protected] YES N/A
To Submit: Press submit and add attachments to email to [email protected]
