Cover Sheet for AWC and IBC Applications (DOCX 24KB)

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Combined AWC and IBC Coversheet
This coversheet contains information to facilitate approved and efficient animal allocation for research.
Rationale:
 Remove confusion regarding which AWC and IBC approvals relate to which project
 Facilitate adherence to approvals
 Facilitate efficient animal allocation for project work
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Project Proposal Questions
Chief investigator’s Name and Discipline
What is your AWC project number and title?
Please note the project number is allocated at the time of submission of your application by the Animal
Ethics Review Sub-Committee (AERSC) Secretary at aersc@flinders.edu.au
a) Does this AWC application request use of GMO animals, GMOs other than animals, or biologically
hazardous materials (microorganisms, human tissue, fluids)? Does it require IBC approval?
If Yes please go to the next question. If no please go to question 4.
b) What is your IBC project number and title?
Please note the project number is allocated at the time of submission of your application by the
Institutional Biosafety Committee Secretary at ibcadmin@flinders.edu.au
c) What type of Dealing is the project: (Check appropriate box)
Will these animals be taken to another facility outside of the Animal Facility (i.e., individual researcher’s
laboratories)? (Check appropriate box)
If yes, please provide the room number and the details if it is a certified facility.
Please note: the use of rooms outside of the Animal Facility must have been approved in the AWC
approval. If this is not the case the use of these rooms will not occur until a modification to the AWC
approved application has been submitted and is approved by the AWC.
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Animals: Please provide strain name in full of all animals involved
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Please provide emergency contact details (mobile phone number) for the Chief Investigator and
Alternate Chief Investigator.
Please note: You must provide both of the above mobile phone numbers and one or other of these people
must be able to be contacted at all times.
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What do researchers want to happen if animals are sick? Check appropriate box.
Chief Investigator’s Declaration: I certify that the above information is correct and that if any changes
occur, including the researchers involved, I will notify the AWC and IBC.
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Response
Name of CI:
Faculty:
AWC Project Number:
Title:
Yes
No
(Check appropriate box)
IBC Project Number & Title:
Microbiological
Exempt
NLRD PC2
DNIR PC2
Yes
NLRD PC1
No
Room number:
Is this facility certified?
Yes
or No
If yes above, what is the Level of Certification
PC1
PC2
Micro
Certification number (N/A if Micro):
Chief Investigator:
Mobile #
Alternate Chief Investigator:
Mobile #
Notify CI
Animal Facility Manager to cull
CI Signature:
Date:
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