/ Department of Primary Industries, Parks, Water and Environment
Animal Ethics Committee
APPLICATION FORM
General Information / Department of Primary Industries, Parks, Water and Environment
Policy Branch, Strategic Services
C/- AEC Executive Officer
GPO Box 44
Hobart, Tasmania 7001
Email:
Web:

This page is for information only. DO NOT submit this page with your application.

Before completing this form, investigators should be familiar with:

  • Australian code for the care and use of animals for scientific purposes, 8th edition, 2013 (the Code) – available online at
  • Guidelines to promote the wellbeing of animals used for scientific purposes2008– available online at
  • Fact sheets are available on the AEC website that may be of use – available online at

Hints on completing this form:

  • Ensure that new Chief Investigators and Alternative Chief Investigators have made arrangements to complete AEC training.
  • Your application should give the AEC sufficient information to satisfy members that the proposed use of animals is justified and complies with the principles of Replacement, Reduction and Refinement.
  • A response is required for each question. Write "not applicable" if necessary – incomplete forms may be returned to applicants for completion before they can be sent to the AEC.
  • Use plain language where possible, avoid the use of acronyms, abbreviations and jargon, and don’t forget to run a spell-check.
  • The application should clearly explain why animals need to be used, why the species and numbers have been chosen and what qualifications each nominated investigator has in performing each of the procedures outlined.
  • The impact of procedures needs to be clearly detailed. Provide a step-by-step explanation of all treatments (e.g. substances, dose rates, routes, volumes, anaesthetics, surgical procedures, etc.) and the expected impacts on animal welfare. Flow charts or sequence-of-events tables are often of assistance.
  • Ensure you have all signatures before submitting this form; unsigned forms cannot be accepted.
  • If you have any problems or queries, contact the DPIPWE AEC Executive Officer on 6165 3144or at . More information is also available on the AEC website.

Submission of the completed form:

  1. DPIPWE applications must be signed by yourdirect Manager and General Manager.External applications must be signed by a person with appropriate delegation of authority within the organisation.
  1. Signed applications must be forwarded to the AEC Executive Officer by the submission deadline (refer AEC Meeting Scheduleon the website). Applications may be submitted byemail to or by hard copy to Executive Officer, DPIPWE AEC, GPO Box 44, Hobart TAS 7001.
  1. The Chief Investigator will receive an email from the AEC Executive Officer to confirm receipt of the application and to advise of the AEC number allocated to the project.

IMPORTANT NOTE

Investigators must not commence any research with animals until the responsible AEC has given approval. This applies also to pilot studies or preliminary trials associated with the main investigation.
/ Department of Primary Industries, Parks, Water and Environment
Animal Ethics Committee
APPLICATION FORM / Department of Primary Industries, Parks, Water and Environment
Policy Branch, Strategic Services
C/- AEC Executive Officer
GPO Box 44
Hobart, Tasmania 7001
Email:
Web:
NOTE: THIS IS NOT A CERTIFICATE OF APPROVAL
FOR VALIDATION OF AEC APPROVAL, A CURRENT APPROVAL CERTIFICATE SHOULD BE SOUGHT

Section A: ADMINISTRATIVE DETAILS

Project Title
ChiefInvestigator
(include title, name & position)
Organisation and Branch
Postal Address
Phone
(include business and mobile)
Email
Proposed Start Date / Proposed Finish Date

A1. Confidentiality

Do you consent to this information being circulated to the AEC? * / YES / NO

* Please note that information will be treated as confidential by the AEC and the AEC Executive Officer. However, by law, information in the possession of this Agency may be disclosed to an applicant under the provisions of the Right to Information Act 2009.

Personal information will be managed in accordance with the Personal Information Protection Act 2004 and may be accessed by the individual to whom it relates on request to the Department of Primary Industries, Parks, Water and Environment (DPIPWE).

A2. Type of application

______

A3. Funding/Publishing

Do you have funding secured for the entire project? / YES / NO

If you answered no, please explain how you intend to fund the proposed project (e.g. what funding arrangements are already in place, what are the funding timelines, what is the process for applying for further funding, etc.).

Is AEC approval required to secure funding or publishing rights? / YES / NO
Do you intend to publish any data or information derived from this project? / YES / NO

Please provide further information where appropriate.

A4. Collaborative Projects

Does this project involve collaboration with other institutions, e.g. other government departments, institutions, companies, universities, or individuals, etc, who are conducting ‘hands on’ work with animals or animal tissues? / YES / NO

If yes, please indicate whether this project requires consideration and approval from another AEC and provide the institution’s name and AEC contact details.

A5. Permits and Licenses

Does this application involve native, imported or protected species, or taking/removing animals from the wild? / YES / NO
Have you submitted relevant permit applications that apply to the use of these species? / YES / NO

Please list the permits or licenses required to carry out any project work and the status of permit and licence applications.

A6. Genetic Modification of Animals

Does the project involve the genetic modification of animals? / YES / NO
If YES, the Chief Investigator must sign the following statement:
I confirm that this project will be conducted in accordance with the requirements and guidelines of the Office of the Gene Technology Regulator.
Signature:
Date:

A7. Nominated Investigators

Detail the qualifications and practical experience of allnominated investigators for the nominated procedures and species. Please be brief but thorough. If an investigator is inexperienced, details of training and/or supervision must be provided.

Name / Position Title / Qualifications (include veterinary registration details, if applicable) /
  1. Specific experience with nominated procedures
  2. Specific experience with nominated species
  3. If inexperienced with either procedure(s) or species, how will experience be gained & who will provide training &/or supervision?

*Chief Investigator / A.
B.
C.
**Alternative Chief Investigator / A.
B.
C.
***Associate Investigators / 1. / A.
B.
C.
2. / A.
B.
C.

*Note: It is an AEC requirement that all new investigators musthave attended an AEC Training Program prior to nomination as a Chief Investigator or Alternative Chief Investigator. Please see the AEC’s Investigator Training Policy Statement(available on the AEC website) for further information.

**Note: This person will assume the responsibilities of the Chief Investigator during any period of absence of the Chief Investigator and must be associated with the institution nominated in

Section A. The AEC must still be notified of the Chief Investigator’s periods of absence.

***Note: AEC training is required during the term of the approved project.

A8. Investigator Experience

Describe/explain the minimum qualifications, experience and/or level of proficiency required to undertake the proposed procedures competently without causing unjustified harm to animals.

A9. Emergency Personnel (section 2.5.6, the Code)*

In the absence of the Chief Investigator, who will be responsible for the management of emergencies and/or providing veterinary assistance, if required?

Name / Role/Qualifications / Contact Details

*Note: The mandatory AEC requirements for dealing with unexpected adverse events and emergency treatment/euthanasia can be found in the AEC Operating Procedures located on the AEC website.

A10. Glossary

Please complete the following box for any scientific or complex terms that can’t be avoided in writing your application. This will assist the lay members of the AEC.

Term / Lay description

Section B: AIMS, BENEFITS, AND JUSTIFICATION(refer to section 2 of the Code)

B1. Project Overview

In plain English, provide a concise overview of the project, including the broad context of the project, the species of animals and general procedures to be used, why the existing knowledge (if available) is inadequate, and linkages with other AEC projects.

B2. Project Aims

In plain English, list the scientific or educational aims and hypotheses of the project. If the project is part of an overall program of work, outline how this relates here.

B3. Project Benefits

In plain English, explain the potential benefits of the outcomes and what is the evidence that supports the use of animals?

B3.1 Teaching Projects

Is the project a teaching project? / YES / NO

If ‘YES’:

Include an outline of how the attainment of educational outcomes will be assessed, including (where applicable):

-National educational outcomes

-Required Vocational Education and Training (VET) package competency achievements

-Endorsed program outcomes

-Other curriculum-related outcomes

B4. Project Justification

In plain English, provide justification for why these animals need to be used in this project, taking into account ethical considerations, the impact of the procedures on the welfare of the animals, and the anticipated scientific or educational value of the project. Provide linkage to the stated aims of the project. Particular justification must be given for potentially severe or ethically contentious procedures, including:

-Severe compromise to animal wellbeing, and for which Replacement, Reduction and Refinement cannot be fully applied for the project to proceed

-Use of non-human primates

Section C: PROJECT DESIGN AND PROCEDURES

C1. Detailed Description of Project Design and Procedures

Provide sequential details of what happens to the animal/s from the time they are captured/targeted/received until the conclusion of the project, detailing the sequence and timing of events (including any repeat procedures or studies). Please refer to sections C1.1 and C1.2 in your answer.

Please include the following information (where applicable):

  • How the animals will be marked, branded or identified;
  • What samples will be taken and how;
  • Methods used to remove bodily fluids (e.g. venous puncture, heart puncture – under anaesthesia or post euthanasia only, etc.), as well as volume and frequency;
  • Methods used to administer substances (e.g. via alimentary canal, intravenously, intraperitoneally, etc.), including dose and route of any substance or treatment given and experience of investigators in these procedures;
  • Surgical and related procedures including dose of anaesthetic, analgesic and tranquilising agents, methods of monitoring their adequacy and side effects, and experience of investigators in these procedures;
  • How animals will be monitored (while restrained, during anaesthesia, during recovery);
  • Precautions being taken to protect non-target species and the environment; and
  • The specific sites/locations where the procedures will be carried out; and
  • Whether any of the procedures outlined are considered to be novel or unusual.

C1.1 Capture Procedures

Will capture devices be used in the course of this project? / YES / NO

If ‘YES’:

If you have selected ‘YES’ to the above, please ensure the following points have been covered in Section C1:

  • What types of capture methods are proposed;
  • The types of capture devices to be used, including full descriptions and dimensions, and how they will be identified;
  • What bait will be used to lure animals;
  • How many capture devices will be set and over what period of time (i.e. detail full trapping regime);
  • How often and at what times the capture devices will be set, cleared and disabled;
  • What capture records will be kept, maintained, and communicated amongst the project team;
  • The maximum time an animal will spend in a trap;
  • The safest time to capture and release the animals;
  • How distress and death of captured animals will be minimised;
  • How the predation of captured animals will be minimised;
  • What precautions will be taken if lactating animals, nesting birds or animals with pouch young are captured;
  • What precautions will be taken in the event of forecast or prevailing inclement weather or extreme temperatures;
  • How animals will be handled or restrained prior to release; and
  • Any other procedures or information relevant to capture.

C1.2. Tracking Technologies

Will tracking or monitoring technologies (e.g. radio collars, transmitting or logging devices, etc.) be used in the course of this project? / YES / NO

If ‘YES’:

If you have selected ‘YES’ to the above, please ensure the following points have been covered in Section C1:

  • The types of devices to be used, including full descriptions, weights (incl. % of animal weight) and dimensions;
  • Provide examples (including published literature) of previous research projects that have successfully used this or similar device and attachment techniques for the taxonomic group listed in section C;
  • Describe how long transmitter/logger will be attached/implanted/remain on animal;
  • How will the transmitter/logger be retrieved;
  • If a collar will be used, describe the break-away or release mechanism;
  • What tracking records will be kept, maintained and communicated amongst the project team; and
  • Any other procedures or information relevant to the use of tracking technology.

C2. Transport

If applicable, explain the method/s of transport to be used in the project, including the type, duration, frequency, confinement, and number of animals. In your answer, outline what the risks are to the animals that will be transported and explain how these risks will be managed.

C3. Housing

If applicable, explain where and how animals will be housed, including the type, duration, number of animals per cage/pen, shelter, bedding, environmental enrichment, day to day husbandry (e.g. diet, nutrition, hydration), and how the normal environment of native animals is approximated. Please also indicate if permission is required to access the proposed facilities.

C4. Inspections*

Has your animal housing or holding facility been inspected by the AEC Animal Monitoring Officer in the last 12 months? / YES / NO

*Note: The AEC may request video-recorded footage or digital photographs of animal housing or activities undertaken in remote locations. Please see the AEC’s Video Footage and Photographs Policy Statement on the AEC website for more information.

C5. Fate of Animals

What will happen to animals at the completion of their involvement in the project?

C6. Policies/Operating Procedures

Will established and current standard operating procedures (SOPs) or policies be followed to minimise impact on animals?* If yes, these will need to be provided with your application. If none are available, will this project lead to the development of new standard operating procedures?

* Please note that SOPs may be submitted to the AEC for use in accompanying project/s or as standalone documents without accompanying project applications. If you wish to submit a SOP for approval by the AEC, please refer to the AEC website for information or contact the AEC Executive Officer. Please note that approval of a SOP does not automatically result in approval to use animals for the purpose of scientific research.

C7. References

Please provide full details of any references referred to in the text of this application in the box below.

Section D: ANIMAL USE AND WELFARE(refer to section 2.5.1 of the Code)

D1.Target Species and Numbers

This table is specifically for the species and numbers you are deliberately targeting. Do not include bycatch – see D1.2.

Please use a separate row for each species and tab to add additional rows as required

Species
(common and scientific names) / Strain (if applicable) / Total no.
proposed for use over the duration of the project * / No. to be killed over the course of the project / Specific Source/Location (include GPS details, if known)

*Note: Nominate the realistic minimum number of animals required to achieve statistically valid results. In the event that additional animals are required, an Amendment Request Form must be submitted for AEC consideration.

D1.1. Animal Selection

Explain how and why these target species/strains and numbers of animals have been chosen, and provide details of sex, age, weight, etc. (if applicable). Outline any relevant criteria or requirements for the selection of animals. If this is a project involving survey or capture of animals, please provide information on how the proposed species and numbers were estimated (e.g. based on previous experience, available information and results of previous fieldwork/literature).

D1.2. Bycatch

If applicable, list the anticipated bycatch and detail how these animals will be treated or dealt with. Include details about what will happen to any feral/pest animals that are captured (refer to relevant legislation where possible).

Please use a separate row for each species and tab to add additional rows as required

Species
(common and scientific names) / Treatment

D2. Replacement(section 1.18-1.20, the Code)

Why is it necessary to use animals in this project? What potential alternatives to using animals in this project have been considered and why have these been rejected as unsuitable?

D3. Reduction(sections 1.21-1.27, the Code)

Explain why the number of animals listed above will be required. If this project represents the repetition of work previously conducted, briefly describe the previous work done and explain why it needs to be repeated. If the investigation involves the use of animals that have been the subject of previous research you will need to describe how they are to be re-used and justify their use in this project. Is there an opportunity to share tissue and other biological matter taken in future projects?

D4. Refinement(sections 1.28 – 1.30, the Code)

What measures have been considered to reduce the impact of the investigation on the animals (e.g. research design, procedures, housing conditions, animal handling)? If invasive methods are to be used, how will pain and distress be minimised?

D5. Monitoring

How will animal welfare be monitored during all phases of the project (e.g. capture, housing, handling, implementation of procedures, and post-release, etc.)? In your answer, include details of the signs to be monitored and the level at which intervention is necessary, who will monitor the animals, the frequency of monitoring, how observations will be recorded, and whether any automated monitoring systems (desirable but not compulsory) will be used.