Page 1
IACUC001A
04/25/2008
of 2
IACUC #
To be completed by SPAR
Winthrop University
Institutional Animal Care and Use Committee
Animal Study Protocol Review
Schedule A: Husbandry
Directions: All questions must be answered. If some questions are not applicable, please answer NA. After completing the
form, print one copy and sign. Submit the original paper copy with signature to Deborah Broome, Office of Sponsored
Programs and Research (Rm. 149 McLaurin Bldg.) as well as an electronic copy via email (broomed@winthrop.edu). The
electronic copy does not need to show the signature.
This schedule is to be completed for all animal studies in which the animals will be housed outside of their natural habitat
in either on campus or field animal facilities.
Principal Investigator:
Project Title:
A1
Animal Species Inventory Information: (The number of species should correspond to the- Animal Use Summary on
the Animal Study Protocol Review IACUC001)
Animal # Animals Housed
Species
Strain
On-Campus location
Field Location
Age
Daily
Yearly
a.
b.
c.
d.
e.
A2
a.
b.
Animal Facilities Location
Address of Site:
Does the site facility comply with
Animal Welfare Regulations?
c.
Does the facility have a license or
permit for operation?
d.
Operating License or Permit:
A3
Yes; State governing regulation:
No; Explain:
Yes; Complete item d.
No; Explain:
Authorizing entity: Give name and Address:
License or permit #:
Are animals expected to reproduce?
Yes; If so, describe rate of expected reproduction:
No
Page 2
IACUC001A
04/25/2008
of 2
Describe and justify below special caging, care, diet, housing, etc.
A4
Describe below special animal restraints other than routine caging and handling.
A5
Signature of Principal Investigator
Date