FORM C
UNIVERSITY COMMITTEE ON LABORATORY ANIMALS
Application to use INVERTEBRATES, tissues obtained at NECROPSY
or obtained from a SLAUGHTERHOUSE
FORM C - INFORMATION
*** This application is for investigators using invertebrate species for research or teaching, for
which the Canadian Council on Animal Care does not require detailed information. This
includes the use of eggs, protozoa or other single-celled organisms; experiments involving
containment, incision or other invasive procedures on metazoa. It is the expectation of the
CCAC that animals of all species, including invertebrates used in research or teaching
projects will be treated humanely including the use of anesthetic or analgesic agents when
appropriate with rapid and humane forms of euthanasia.
*** This category excludes higher invertebrates with complex nervous systems (ie. all cephalopods)
- for these species, detailed information on the FORM A application is required.
*** This application may also be used for investigators wishing to use tissues obtained at necropsy
or from a slaughterhouse.
Information requested on this form will enable the office for the University Committee on
Laboratory Animals to sign investigator's grant application forms to indicate that the UCLA has
approved the proposed use of invertebrates, tissues obtained at necropsy or from slaughterhouse
as required by many granting agencies.
Please send electronic version and one signed paper copy to UCLA secretary.
Approval of this application will extend the project for a two year period. At the end of this period
you will be required to re-submit another Form C.
Jennifer Wipp
Administrator - UCLA
Dalhousie University
PHONE:
FAX:
EMAIL:
494-1270
494-1516
UCLA@dal.ca
FORM C
UNIVERSITY COMMITTEE ON LABORATORY ANIMALS
PROTOCOL NUMBER
Application to use INVERTEBRATES, tissues obtained at NECROPSY
or obtained from a SLAUGHTERHOUSE
PRINCIPAL INVESTIGATOR (Faculty member):
DEPARTMENT:
POSITION:
PHONE:
FAX:
PROJECT TITLE:
FUNDING SOURCE:
OBJECTIVES of PROPOSED ANIMAL USE:
SPECIES TO BE USED:
APPROX. # USED ANNUALLY:
SOURCE OF TISSUE / SPECIMENS:
METHODS OF ANESTHESIA/EUTHANASIA (IF APPPLICABLE):
BRIEF DESCRIPTION OF PROCEDURES TO BE USED:
DECLARATION: All animals used in this research project will be cared for in accordance with the recommendations
of the Canadian Council on Animal Care and the policies of Dalhousie University.
PRINCIPAL INVESTIGATOR:
APPROVED BY THE ANIMAL CARE COMMITTEE:
DATE:
DATE: