Application Form for Scientific Expedition in Greenland

Application Form for Scientific Expedition in Greenland

Application form for scientific expedition in Greenland

The completed form must be send to:

Mineral Licence and Safety AuthorityPhone: +299 34 68 00

P.O. Box 930E-mail:

3900 Nuuk, GreenlandWebsite:

Reserved for the MLSA

General Information

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Date of arrival in GreenlandDate of departure from Greenland

(expedition start) (expedition end)

Name of institution and/or title of expedition

Number of participantsName of expedition leader

Information on expedition leader

Address
Citizenship
Date of birth
Phone
Fax
E-mail

Name, address and contact information of contact in home country during the expedition

Name and address of any local contact in Greenland

Have you applied for a permit before?

YES / NO

If yes,licence number:Time period:

Will the expedition need access to the National Park?

(Please note that expeditions in the National Park are required to bring a firearm)

Yes / NO

If yes, please include a firearm permit to your application. You can download the firearm application form from permit must be obtained from the Chief Constable of Greenland .

Activity area in Greenland

(Indicate local geographical longitude and latitude of boundaries and base camp locations.

Enclose a map – preferably in scale 1:250.000 – with the information)

Which radio equipment will be used in Greenland apart from PLB which is compulsory?

Description of expedition objectives in Greenland

(Include specification of minerals, no. of samples, quantity – kg, geological methods)

Logistics

Means of transportation to and from the activity area

Means of transportation in the activity area

Will you be bringing firearms?

Yes / NO

If yes, you will need a firearm permit, cf. page 2

Do you plan airdrop(s)?

Yes / NO

If yes, state locality / localities:

Access to the below locations will be required (check appropriate)

Station Nord* / Daneborg* / Mesters-vig* / *Permission required from Arctic Command,
e-mail:
Thule Air Base / Only research projects can be permitted. Permit required from Ministry of Foreign Affairs,

Description of emergency, safety and general equipment to be used

Report any change before departure for Greenland.

By my signature below I confirm

that all participants in the expedition will be made aware of the content of the

MLSApermit to scientific sampling,and further that the information

submitted in this application form can be made public.

Place and date:Signature of responsible leader:

Title of expedition

Compulsory information about participants

Participant 1

Name
Address
Citizenship
Date of birth
Phone
E-mail

Any known medical conditions, handicap or allergies?

Yes / NO

If yes, state details of any medications:

Participant 2

Name
Address
Citizenship
Date of birth
Phone
E-mail

Any known medical conditions, handicap or allergies?

Yes / NO

If yes, state details of any medications:

Participant 3

Name
Address
Citizenship
Date of birth
Phone
E-mail

Any known medical conditions, handicap or allergies?

Yes / NO

If yes, state details of any medications:

Participant 4

Name
Address
Citizenship
Date of birth
Phone
E-mail

Any known medical conditions, handicap or allergies?

Yes / NO

If yes, state details of any medications:

Participant 5

Name
Address
Citizenship
Date of birth
Phone
E-mail

Any known medical conditions, handicap or allergies?

Yes / NO

If yes, state details of any medications:

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