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Macquarie University
Animal Ethics Committee
Request for Amendment to Animal Research Authority
Change of Personnel
(Version 9 – May2015)
Principal Investigator / Supervisor (please complete)
Name (Title, First name, Surname)Protocol Number (ARA)
Project title
Reason for request / Adding New Personnel Removing Personnel
SECTION 1: REMOVING PERSONNEL FROM A PROTOCOL
(Please complete this section if you are REMOVING an investigator from a project)
Name (Title/first name/surname):Date of Departure:
Protocols personnel to be removed from:
Please list all the currently approved personnel remaining on the protocol:
Signature of Principal Investigator:
Date:
Details of Person to be Added to Protocol (please complete)
Please note that the addition of any new personnel is conditional to all researchers having completed the relevant RACE training. Please email to with your full name, MQ ID and which department you are working under to enrol for the course. Please note: You will not be added to Animal Research Authorities until a certificate has been issued.
SECTION 2: ADDING NEW PERSONNEL
(Please complete this section if you are ADDING an investigator to a project)
2.1. / NameTitle/first name/surname
Relevant qualifications, experience and training in animal research
Position on this project
(e.g. Associate Investigator)
If student: / Degree enrolled in
MQ Student ID
If staff: / MQ Staff ID
MQ Department
Telephone (MQ Extensionor a local contact number)
& Mobile
2.2. / Has this person attended an Animal Ethics or Welfare course? / Yes
No
If YES / Course name and convening institution (e.g. Macquarie University “RACE Training” or the University of Sydney “Introduction to Animal Research” course
Date
Was the course passed? / Yes No
The research office has my certificate on file / Yes No
Attach a copy of course certificate / Attached
If NO / Please email towith your full name, MQ ID and which department you are working under to enrol for the course.
2.3. / Have any proposed researchers on this application had any AEC approval withdrawn or been suspended from working with animals for any period? / Yes
No
If yes, please provide details (including the ARA number, the date on which the approval was withdrawn/suspended (and if applicable, the date on which approval was reinstated) and the reasons stated by the AEC for withdrawal/suspension)
What changes were made as result of the withdrawal/suspension?
(e.g. extra training/ education, investigations, modifications to the project, etc.)
2.4. / Give details of specific duties or tasks the person will be involved with or responsible for (e.g. anaesthesia, tagging, etc.)
Experience with techniques to be performed on live animals by this person IN THIS PROJECT:
(add or delete rows as necessary)
Technique or Procedure / Species / Level of RECENT experience
(Approx. number of times this person has performed the procedure in this species in the recent past) / Name of experienced senior staff on project who will supervise (if "None" or "Limited")
None / Limited (e.g. <20) / High
(e.g. >20)
DECLARATION OF REPONSIBILITIES:
Principal Investigator to complete:
I certify that the use of animals in this project will conform to the Australian Code for the Care and Use of Animals for Scientific Purposes (NHMRC 8th Ed. 2013) and the NSW legislation. I accept responsibility for the conduct of all procedures detailed in the approved application, and for the supervision of all personnel delegated to perform any such procedures.
Principal InvestigatorDate:
(signature)
New person to complete:
I confirm that I have read the protocol application nominated above and agree to comply with the procedures described and any conditions imposed by the Macquarie University Animal Ethics Committee. I have read the Australian Code for the Care and Use of Animals for Scientific Purposes (NHMRC 8th Ed. 2013) and the NSW Animal Research Act 1985 and NSW Animal Research Regulation 2010and agree to work within these codes.
New personDate:
(signature)
AEC Amendment - Change of Personnel Request Form v9 - May 2015