LIQUID JUNGLE LABORATORY
RESEARCH PROPOSAL AND APPLICATION
Scientists, University Faculty, Graduate Students, Post Docs, and Individual Research Fellows
seeking to conduct research or field studies at the Liquid Jungle Laboratory (LJL) are
required to submit
a Research Proposal and Application that describes funding sources,
timeline, project rational, and methods.
This information is used to evaluate the project
research merits and proposed activities as well as determine laboratory space, equipment,
lodging, and necessary permits from the Republic of Panama.
Long term research in residence can be arranged with the LJL when required.
Field courses
for graduate or undergraduate students may be requested on a case by case basis.
Submission of this application does not imply that the project is approved.
Applications are
reviewed on a quarterly basis throughout the year and must be received at least THREE
months before proposed research is intended to begin.
Application Deadlines: Midnight GMT: January 15, April 15, July 15, October 15.
A scientific peer review board reviews project proposals and the applicant will be notified via
email if the project is approved.
Pending Application and Research Proposal approval, it is
the responsibility of each researcher to obtain all required Permits for collection, observation,
marking, import or export of samples and specimens in Panama. For additional information
visit www.liquidjunglelab.com
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
APPLICANT INFORMATION:
NAME:
AGENCY OR INSTITUTION:
POSITION OR TITLE:
DEPARTMENT:
EDUCATIONAL BACKGROUND:
PROFESSIONAL BIOGRAPHY / RESEARCH INTERESTS / EXPERIENCES (~ 250 WORDS).
PASSPORT SIZE PHOTO:
(digitally insert or paste and scan application)
APPLICANT CONTACT INFORMATION
INSTITUTIONAL OR PRIMARY ADDRESS
Street
Bldg/Office
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
City
State
Zip/Postal
Country
Phone
Fax
E-mail
Citizenship
Advisor/P.I./Supervisor:
Name
Institutional Address
Phone
e-mail
Phone
e-mail
Emergency Contact Information:
Name
Relationship to Applicant
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
CITIZENSHIP & VISA REQUIREMENTS
Are you and/or your assistants eligible for a tourist, student or research Visa in the Republic
of Panama?
How many days is your group eligible to reside in the Republic of Panama?
PRIMARY RESEARCHERS OR ASSISTANTS
Primary Collaborator or Assistant #1
(digitally insert or paste and scan application)
Name
Institutional Address
Citizenship
Primary Collaborator or Assistant #2
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
e-mail
LIQUID JUNGLE LABORATORY
(digitally insert or paste and scan application)
Name
Institutional Address
Citizenship
e-mail
Primary Collaborator or Assistant #3
(digitally insert or paste and scan application)
Name
Institutional Address
Citizenship
PROJECT TITLE OR THESIS QUESTION:
Summarize Your Scientific Investigation in the fields provided.
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
e-mail
LIQUID JUNGLE LABORATORY
PROJECT ABSTRACT; ≤ 250 WORDS.
INTRODUCTION / PREVIOUS RESEARCH ≤ 250 WORDS.
RESEARCH OBJECTIVES AND HYPOTHESIS ≤ 250 WORDS:
METHODS * ≤ 250 WORDS:
*There are long term experiments underway at LJL. Identify potential environmental impacts or
alterations to LJL, Rosario, or the nature preserve. Describe tagging methods, animal handling
protocols, specimen collection, preservation techniques and specialized field equipment. If radio
telemetry is to be used, detail all frequencies.
JUSTIFICATION ** ≤ 100 WORDS:
**why performing the proposed research at LJL is advantageous and/or provides opportunities or
resources unavailable elsewhere
PROFESSIONAL OR ACADEMIC REFERENCES
Name
Institution
Phone
e-mail
ATTACH (1) LETTER OF RECOMMENDATION IN SUPPORT OF YOUR PROJECT FROM ONE OF THE ABOVE
REFERENCES AND EMAIL AS AN ATTACHMENT OR INCLUDE WITH YOUR MAILED APPLICATION .
RESEARCH TIMETABLE
I propose to be in residence at Liquid Jungle Lab from ___________. through _____________. with
alternate dates of _____________through __________________.
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
*Applications are processed as they are received and do not guarantee space or availability
for requested dates. The laboratory is closed during Christmas Break and Panamanian
National Holidays.
EQUIPMENT AND FIELD OPERATION SUPPORT
Will you require laboratory space?
Will you be using isotopes or radioactive tracers? If so describe.
Will you require use of outdoor seawater tanks and live wells?
Describe if you will use chemicals, gasses, or hazardous materials.
Describe use of specialized laboratory equipment in your study.
Does your research require use of a small boat – (how many hours/day)?
Do you plan on shipping equipment to the laboratory? (If Yes, Describe Contents,
Shipping Methods and Approximate Volume and Weight)
PERMITS AND SPECIMEN COLLECTION
The Liquid Jungle Lab (LJL) requires all individuals conducting research to adhere to the
laws and regulations pertaining to the legal collection, import and export of scientific
specimens as described by the laws of the Republic of Panama, your particular Institutional
requirements, and other international conventions (e.g., Convention on International Trade
in Endangered Species CITES & Institutional Animal Care and Use Committee
IACUC).
Describe any samples you will be collecting (i.e. water, soil, rock, sediment, bacteria,
fungus, plants, algae etc…)
Will you be collecting plants or animals? If so describe and list common name, and
genus – species.
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
Does your project involve the use of human subjects or archaeological sites or indigenous
groups?
Does your project involve the use of vertebrates?
If yes, please attach a scanned copy of an approved IACUC solicitation for your project obtained
from your respective university or collaborating institution.
Will your research be conducted within the Coiba National Park or MPA?
If you plan on conducting field research within the boundaries of the Coiba National
Park or the adjacent special Marine Protected Area (MPA), you must contact the
Autoridad Nacional del Ambiente (ANAM), http://www.anam.gob.pa in Panama to
obtain collection and export permits at least ten weeks in advance of the scheduled
date of field operations.
Will you be importing or exporting organisms, samples, or specimens? If so describe
what, how and where.
There are different permits needed depending on the area in which collections will be made
and a thorough guide to the necessary requirements for Research Permits in Panama can be
found at: http://www.stri.si.edu/english/research/applications/permits/index.php
Note: Researchers attempting to operate without appropriate permits will be denied use of
LJL facilities.
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
BUDGET INFORMATION:
PRIMARY FUNDING SUPPORT
(e.g. indicate if self funded, contract, scholarship, fellowship, institutional support, university stipend,
post doc position, internship, corporate sponsorship, or salary).
LIST FUNDING SOURCES:
.
Total Research Budget Amount ($)
Estimate Total Number of Days in Residence
Estimate Total Number of People
Estimate Total Hours Boat Use
For current LJL facility rates visit website: www.liquidjunglelab.com
BILLING INFORMATION – INVOICE CONTACT INFO:
Name
Institution
Street
City
State
Zip/Postal
Country
Phone
Fax
E-mail
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
SCUBA DIVING PROTOCOL
The LJL complies with the best practices of current SCUBA dive standards outlined by the AAUS American
Academy of Underwater Sciences (http://www.aaus.org).
Does your research involve the use of SCUBA? Choose an item.(if No, go on to next section)
Indicate Organization and Certification Level for Each diver in table below:
# dives this
Diver Name
Organization
Certification
License #
yr
List divers who are active Research-Certified SCUBA divers.
List divers who carry Divers Alert Network (DAN) or similar insurance.
Is your Institution AAUS affiliated?
List divers who have had a Physical Examination in the last 3 years
Pending Application Approval, your Institutional Dive Safety Officer (DSO) will provide the LJL Diver Safety
Officer with a Letter or Recommendation (LOR) verifying each diver's status, certification and dive history.
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
DSO Name
Institution
Phone
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
e-mail
LIQUID JUNGLE LABORATORY
INSURANCE AND LIABILITY
If selected, the Applicant’s signature on this form indicates that (she/he) understands that
it is the Applicant’s responsibility to obtain health and emergency evacuation insurance
through the home institution or a private policy, and that the Applicant waives any claims
against Liquid Jungle Laboratory (LJL), the Science Director, and any LJL staff,
employees, affiliated organizations, researchers, or their representatives, for illness,
accident or injury during the Applicants tenure, field work, laboratory time or during travel
to and from the LJL.
SIGNATURE OF RESPONSIBLE PARTY
My signature (Applicant) below confirms that I have read and accepted the conditions and
policies listed in this application and that the information I have provided is to the best of my
knowledge, correct.
Print Name
Date:
Signature
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com
LIQUID JUNGLE LABORATORY
(If necessary you may print, sign, and scan this page separately and attach it to email with completed application)
Calle 49 Bella Vista, Edificio Grecia, Planta Baja, Local #2
Panamá, Ciudad de Panamá, Republica de Panamá
www.liquidjunglelab.com