Application for AEC
Approval
Animal Ethics Committee
All projects which involve the use of animals for research or teaching (or other activity) MUST go to a full meeting
of the Federation University Australia Animal Ethics Committee (AEC).
AEC Meeting dates & Agenda Item due Dates can be found at:
http://federation.edu.au/research-and-innovation/research-support/ethics/animal-ethics/aec-meetings
Projects must not commence without prior written approval from the AEC.
PLEASE NOTE: The DVCR&I states AEC Approval can be revoked if Annual and/or Final Reports are not
received by the required annual deadline, as the University is required to report annually to the State
Government.
Completing the Form
This form can be completed on your computer. Use the tab key to move to areas in the form that require a
response and enter your response. The response area will expand to fit the content you are entering. Click inside
a checkbox to record a Yes/No response. Use Lay language to explain your research proposal. Electronic
Signatures can be applied, or signatures obtained in required spaces once the completed form is printed.
The Committee will assess your application based on the requirements outlined in the NHMRC Australian Code
for the Care and Use of Animals for Scientific Purposes 8th Edition 2013, particularly the 3 R’s (Replace,
Reduce, Refine).
http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ea28_code_care_use_animals_130728.pdf
All applicants are also expected to have read the ‘Federation University General Guidelines for Wildlife
Capture and Handling’ http://federation.edu.au/__data/assets/pdf_file/0019/151606/Fed-Uni-GeneralGuidelines-for-Wildlife-Capture-and-Handling.pdf
For further details about completion of this form contact your supervisor. Ethics officers can be contacted at:
research.ethics@federation.edu.au or phone: 5327 9765 - 5122 6446.
Attachments
Before submitting your application, please check that you have attached copies of all required supplementary
documentation.
 Evidence of permission to use public or private places off-campus (where applicable);
 Evidence of approval by other Ethics Committee(s) (where applicable);
Authorisations
The Project Supervisor is responsible for ensuring that all regulated approvals and clearances have been
obtained prior to undertaking any aspect of the project;
Please check that you have obtained all required signatures before submitting application:
 Principal Researcher, and Other Researchers, then
 Head of School, or
 Deputy Head of School, or
 ADR, or
 School Ethics Coordinator (Mt Helen only).
*****Please remove this page before submitting application*****
CRICOS Provider No. 00103D
Page 1 of 14
Application for AEC
Approval
Animal Ethics Committee
Note from the Animal Ethics Committee:
When field based or wildlife Animal Ethics projects occur on traditional owner land,
the researchers when appropriate, may find it beneficial to identify and liaise with
local Indigenous groups utilising their expertise in the area of the project.
****Please remove this page before submitting application*****
CRICOS Provider No. 00103D
Page 2 of 14
Application for AEC
Approval
Animal Ethics Committee
PLEASE TYPE YOUR RESPONSES INTO THE BOXES PROVIDED. BOXES WILL EXPAND TO FIT YOUR
RESPONSE.
PROJECT DETAILS:
Title of Project:
What type of project is this? (Tick as many as apply)
Funded Consultancy
Practical Class
PhD
Honours
Clinical Trial
Student Research Project
Masters
Undergraduate
Staff Research Project
Doctorate
Postgraduate Diploma
Other ..........................
Through which School/Section is the project to be conducted?
What is the proposed duration of the project?
From:
To:
The project will take place in:
VIC
NSW
TAS
QLD
ACT
NT
SA
WA
PERSONNEL:
Principal Researcher (STAFF MEMBER ONLY)
Responsibility for effective oversight and proper conduct remains with Project Supervisor
Title & Name:
Position:
School/Section:
Phone number:
Email address:
Please list academic
qualifications:
Describe what this
researcher will do in the
context of this project:
Include a brief summary
of relevant experience for
this project:
CRICOS Provider No. 00103D
Page 3 of 14
Application for AEC
Approval
Animal Ethics Committee
Student/Other Researcher/s
**copy and paste this table for each person involved in the project
Title & Name:
Position:
School/Section:
Phone number:
Email address:
Student ID number:
Please list academic
qualifications:
Describe what this
researcher will do in
the context of this
project:
Include a brief
summary of relevant
experience for this
project:
PROJECT DESCRIPTION:
1.
Lay summary of the project:
Provide a brief outline of the project, describing in plain language the key aspects of the
project.
2.
Aims/rationale/research question(s) and background of the
project:
State the aims, research objectives, key research questions, and significance of the
project. Where relevant, state the specific hypothesis to be tested. Also please provide
a brief description of the relevance of your proposed project to current research, a
justification as to why your research should proceed, and an explanation of any expected
benefits of the study.
3.
Subjects:
Provide a brief description of the subjects to be used in the project - the sample size, the
source of the subjects, and the means by which they will be collected.
CRICOS Provider No. 00103D
Page 4 of 14
Application for AEC
Approval
Animal Ethics Committee
4.
5.
Procedure:
Justification:
What is the potential benefit to humans or animals as per the NHMRC Australian code of
practice for the care and use of animals for scientific purposes?
To obtain and establish significant information relevant to the understanding of
humans and/or animals
To maintain and improve human and/or animal health and welfare
To improve animal management or production
To obtain and establish significant information relevant to the understanding,
maintenance or improvement of the natural environment
To achieve educational objectives
SUBJECT DETAILS:
6.
Animals (vertebrates only) to be used:
Species Name
Common Name
Source or
location
7.
Are any of the species listed above endangered?:
8.
Justification for the number and species of animals required:
9.
Have any of the animals been the subject of previous projects?
If ‘yes’, please justify their use and explain how they will be identified.
CRICOS Provider No. 00103D
No. to
be
handled
Page 5 of 14
Application for AEC
Approval
Animal Ethics Committee
10. Animal handling and care.
10.1 Describe how the animals will be handled and cared for:
Provide details of monitoring, trapping, acquisition, transportation, storage, housing,
watering & feeding, treatment.
10.2 Location of animals during project:
NB: Research locations / facilities (other than field research sites) need to be inspected
and approved by the AEC.
Building/Room (if on Campus):
Off Campus (please specify location):
REPLACEMENT, REDUCTION & REFINEMENT:
(see Australian code of practice for the care and use of animals for scientific purposes – section
1.8 to 1.28)
11. Replacement - Explain why animal use provides better educational outcomes than
available non-animal use alternatives e.g. DVD, internet:
12. Reduction – What controls will be put in place to reduce the impact on the
animals?
13. Refinement – How will pain/distress of animals be minimised? How have the
researchers ensured that the techniques to be used are the most
appropriate/most efficient?
PERMITS, LAWS, REGULATIONS & LICENCES:
14. Is the acquisition, retention or use of the experimental animals (eg. Protected
Native or Imported Species) subject to any permit, law or regulation of the state or
Commonwealth?
CRICOS Provider No. 00103D
Page 6 of 14
Application for AEC
Approval
Animal Ethics Committee
No
Yes
If ‘yes’, please specify:
Wildlife Act and Regulations
Prevention of Cruelty to Animals Act
Australian National Parks and Wildlife Service
Fisheries Act (Fish)
Other (Please specify below)
http://www.depi.vic.gov.au/agriculture-and-food/animal-health-and-welfare/animalwelfare/animal-welfare-legislation/victorian-codes-of-practice-for-animal-welfare
15. Is approval being sought from the relevant authority?
No
Yes
If ‘no’, please explain below:
16.
Will the conditions specified by the permit, law or regulation be adhered to?
No
Yes
If ‘no’, please explain below:
If special conditions relating to animal welfare issues for this project are already
known when completing this form, please list below:
CRICOS Provider No. 00103D
Page 7 of 14
Application for AEC
Approval
Animal Ethics Committee
EXPERIMENTAL TECHNIQUES & PROCEDURES:
17.
Justification for any repetition of previously performed procedures (please
give previous AEC approval number if relevant):
18.
Outline of experimental techniques and/or procedures to be carried out on
animals:
19.
Cause of pain to animals.
19.1 Will any anaesthetic, analgesic, tranquilising or neuromuscular blocking
agents be used?
No
Yes
If ‘yes’, please complete the table below.
Name of agent
Type of agent
Dose
Describe the methods and observations to ensure the adequacy of the agent(s).
Please include references to previous studies which have used these agents, as well
as potential problems and side effects:
19.2
Will any animal suffer pain or distress at any time?
No
Yes
If ‘yes’, please describe and justify the cause of the pain or distress and the steps
taken to avoid or minimise it:
CRICOS Provider No. 00103D
Page 8 of 14
Application for AEC
Approval
Animal Ethics Committee
20.
Danger, health risks or ill effects.
20.1 Will any of the following biohazards listed below be used?
If ‘yes’, please specify:
Toxins
Carcinogens
Drugs
Mutagens
Teratogens
Radioactive Substances
Other (Please specify):
20.2 Explain the possible dangers, health risks, or ill effects of any biohazards
or procedure to the animals and staff:
20.3
Outline the precautions taken to minimise dangers, health risks or ill
effects to animals and staff:
21. Disposal of animals.
21.1
Will any animals be killed deliberately during or at the end of the project?
No
Yes
If ‘yes’, how many will be killed? How will they be killed? Please justify the need to
kill:
Who will undertake the euthanasia of animals, if required? Has this person had the
necessary training to undertake the required procedures (please provide details)?
CRICOS Provider No. 00103D
Page 9 of 14
Application for AEC
Approval
Animal Ethics Committee
21.2
How will unintentional animal mortality be dealt with?
21.3
What will happen to the remains of dead animals?
21.4 Please give details of what will happen to live animals at the end of the
project?
22.
Are there any special ethical issues raised by the proposed project?
No
Yes
If ‘yes’, please specify:
What is your response to these issues?
23.
Please list the emergency contacts that you have identified for the purposes of
this project (i.e. local veterinarians etc):
24.
Please describe how any injured animals will be transported to veterinarians for
treatment:
CRICOS Provider No. 00103D
Page 10 of 14
Application for AEC
Approval
Animal Ethics Committee
ENDORSEMENT OF STATISTICIAN/BIOMETRICIAN:
Wherever possible, applications should be endorsed by a statistician/biometrician, or
reference to an appropriate statistical text must be provided.
Statistician/biometrician:
Signature:
Date:
If the project is not endorsed by a statistician, please give a justification for this:
TRAINING REQUIREMENTS:
*****Please copy and paste the following table for each person involved in the
project*****
Name:
Does this applicant require
training in any of the
techniques to be used?
YES
NO
If yes, details are required including who is to give the training:
If training is to be provided to
this applicant, how will their
competency in the technique
then be tested?
List ALL procedures this person will be undertaking (including possible procedures e.g.
euthanasia) and their level of experience with this species
Species
Technique/
Level of Experience:
procedure
Please give details of the
training/experience in relation to the
technique/procedure
CRICOS Provider No. 00103D
Page 11 of 14
Application for AEC
Approval
Animal Ethics Committee
PERSONNEL DECLARATION:
DECLARATION BY PROJECT SUPERVISOR (Must be a staff member)
I (the researcher) acknowledge that when wildlife and field based projects are carried out on
traditional owners land, I would like to acknowledge the Traditional Owners of the land
on which this research is taking place and pay my respect to their Elders, past and
present.
I hereby declare that I have the appropriate qualifications and experience to
perform the procedures described in this Application or to ensure that they are
done correctly.
I have read the provisions of the Prevention of Cruelty to Animals Act 1986),
incorporating Amendments as at 1 July 2014, (the Act)
http://www.depi.vic.gov.au/agriculture-and-food/animal-health-and-welfare/animalwelfare/animal-welfare-legislation/prevention-of-cruelty-to-animals-legislation
and the NHMRC Australian Code of Practice for the Care and Use of Animals for
Scientific Purposes 8th Edition 2013 (the Code).
http://federation.edu.au/__data/assets/pdf_file/0015/151521/Australian-code-forthe-care-and-use-of-animals-for-scientific-purposes.pdf
I accept responsibility for the conduct of the procedures detailed above, in
accordance with the requirements of the Act and the Code and any other
conditions laid down by Federation University Australia Animal Ethics Committee.
I further declare that the procedures described in this Application do not constitute
unnecessary repetition of work previously carried out by other research workers or
myself (Section 1.11 of the Code).
I declare that all persons engaged in this project have been adequately instructed
in, and are competent to perform, procedures they are to carry out. If they are not
already skilled in the procedures, I will be responsible for ensuring that they obtain
the necessary training, so that each procedure on an animal will be carried out in
the most appropriate manner.
I declare that all persons engaged in this project have copies / or access to copies
of this Application form.
I acknowledge and declare that I am responsible for ensuring that all regulated
approvals, permits and clearances have been obtained prior to undertaking any
research described in this Application.
I understand that I am required to supply annual and final reports in January
each year as a condition of approval.
Name of Project Supervisor
Signature
Date
(must be a staff member)
CRICOS Provider No. 00103D
Page 12 of 14
Application for AEC
Approval
Animal Ethics Committee
DECLARATION BY ALL PERSONNEL INVOLVED IN ANIMAL USE
I hereby declare that I have the appropriate qualifications and experience or will
be trained by the person specified to perform the procedures as described in this
Application.
I have read the above application.
I have read the provisions of the Prevention of Cruelty to Animals Act 1986),
incorporating Amendments as at 1 July 2014, (the Act)
I have read the NHMRC Australian Code of Practice for the Care and Use of
Animals for Scientific Purposes 8th Edition 2013 (the Code).
I agree to submit to the authority of the Principal Researcher and the Scientific
Licence Nominee for the purposes of collaboration on this project.
Name(s) of additional personnel
Signature
Date
Declaration by designated Head of School OR Deputy Head of School
OR
Associate Dean of Research (ADR)
I have reviewed this project and consider the methodological/technical aspects of the
proposal to be appropriate to the tasks proposed and recommends its approval. I consider
the applicant(s) has/have the necessary qualifications, experience and facilities to conduct
the project proposed and to deal with any emergencies and contingencies that may arise.
Comments/Provisos:
HOS /
Deputy HoS /
ADR
SIGNED:
PRINT
NAME:
DATE:
CRICOS Provider No. 00103D
Page 13 of 14
Application for AEC
Approval
Animal Ethics Committee
******PLEASE NOTE: The AEC reserves its right to inspect / attend any field work /
procedure, to ensure that conditions of the permit are adhered to. Applicants need to
make themselves available to facilitate such inspections if required, and to supply
their contact details and a time frame for field work etc when requested to do so******
CRICOS Provider No. 00103D
Page 14 of 14