Comparative Medicine Responsible Care And Use Of Laboratory Animals (RCULA) Training Program Registration Form (External) Full Name and email are required. Incomplete Forms will not be processed. NOTE: Cheque Payment is preferred. For cash payment, the exact amount must be given as no change will be provided. Section A ------------------------------------------------------------------------------------------------------------------------ Full Name Company Title/ Function Department Email Contact Number PI or Supervisor’s Name & Email Course RCULA RCUF Section B Type of species (ONLY choose the species that you will be working with) Mouse Frogs (ONLY online module available) Rat Others/Other Aquatics (ONLY online module available) Aseptic Surgery Rabbit Guinea Pig Pig Fish Note: *Aseptic Surgery training is required for animal users performing animal surgeries routinely. Biopsy, necropsy and animal tissue harvesting are not considered surgical procedures. Section C Husbandry Restraint/Handling Surgery Wildlife/Field Observation Blood Collection Injection Gavage Anesthesia Type of animal contact Animal Biosafety level 2/3 Work Bloodborne Pathogens Work Cytotoxic* Work Others (e.g Breeding, etc) Section D Type of Personnel Research Staff/Personnel named on IACUC protocols Undergraduate/Post – graduate Students IACUC Members Animal Care Staff Maintenance and custodial workers Visitors Others Section E RCULA and RCUF Pre - Requisites Prior to all RCULA and RCUF hands on training, external participants must: make complete RCULA relevant course payment to Comparative Medicine complete all the relevant assigned online modules receive tetanus vaccination from NUS Occupational health clinic or any other licensed medical clinic (at participant’s own cost) Section F RCULA Hands On Training and online modules Charges National University of Singapore Comparative Medicine Animal Course Charges for External Participants Program (Species Specific Hands on) Include mandatory online modules UOM RCULA (introductory hands-on only) Mice Pig Rat Aseptic Surgery Rabbit Guinea Pig Mice and Rat Online Module Part 1A and relevant modules ONLY Approved External Fees Exclude GST (SGD) Approved External Fees Inclusive of GST (SGD) $140.00 $150.00 $190.00 $200.00 $210.00 $250.00 $250.00 $149.80 $160.50 $203.30 $214.00 $224.70 $267.50 $267.50 per pax per pax per pax per pax per pax per pax per pax per pax $70.00 $74.90 RCUF Fish per pax $180.00 $192.60 Methods of Payment and Payment Advice 1) Bank Draft/Cheque should be made payable to “ National University of Singapore “Please complete the registration form and return it with payment to: National University of Singapore Comparative Medicine, Centre for Life Sciences, 28 Medical Drive, #05-02 S’pore 117456 Attn: CM Finance Note: Please write your name, contact # & the specific hands on training session on the reverse side of the cheque. (e.g. NAME/TEL/RCULA or RCUF) 2) For further billing enquiries, please contact: Email - annwee@nus.edu.sg NOTE: Please provide billing/mailing address below: Section G RCULA and RCUF Administrative fees After RCULA course payment, All RCULA participants (Externals) are allowed a maximum of 3 re – schedules (EXCEPT medical leave) of RCULA Hands On Training Dates. The 4th RCULA training date re – schedule will result in an administrative charge of full course fee (selected) by Comparative Medicine. An administrative charge equivalent to the full course fee (selected) will be levied by Comparative Medicine will be enforced to all RCULA/F participants (Externals) with NO SHOW on actual day of training with no prior notification to the RCULA team.(EXCEPT medical leave) RCUF hands on charges is currently $180 (w/o GST) for RCUF participants (Externals). All RCUF participants (Externals) are allowed a maximum of 3 re – schedules (Except medical leave) of RCUF Hands On Training Dates. The 4th RCUF training date re – schedule will result in an administrative charge of $150 plus full course fee (selected) by Comparative Medicine. Type of Admin Charge/Category NO SHOW 4th Re‐schedule NUS Students/Staff S$125 S$125 External Participants Full Course Fees S$150 + Full Course Fees Note: Comparative Medicine reserves the right to re - schedule your RCULA hands on training to a later date (Maximum of 3 re – schedules and based on availability) if: the online modules are not completed before the scheduled date of hands on training tetanus vaccination is not taken before the scheduled date of hands on training Late arrival or early departure of more than 20 minutes on the actual day of training Please inform us 5 business days in advance in the event of no show on scheduled date of hands on training List of NUS – CM Tracks: A. B. C. D. E. F. G. NUS – CM Species-Specific Anesthesia, Analgesia, and Surgery Occupational Health and Safety Animal Biosafety Concepts US Mandates and Guidelines Facilities, Supplies, and Materials List of available RCULA and RCUF online modules specific to the NUS – CM tracks above: 1. Responsible Care and Use of Laboratory Animals (RCULA) Part 1A: Biomedical Research and Teaching 2. Responsible Care and Use of Laboratory Animals (RCULA) Part 1B: Wildlife and Field Studies 3. Responsible Care and Use of Laboratory Animals (RCULA) Part 1C: Fish for Scientific Purposes (RCUF) 4. Working with the Laboratory Mouse 5. Introduction to Rats 6. Mouse Breeding Colony Management 7. Introduction to Swine 8. Introduction to Rabbits 9. Introduction to Guinea Pigs 10. Working with Laboratory Xenopus 11. Working with Laboratory Zebrafish 12. Laboratory Animal Allergy (2014) 13. Bloodborne Pathogens Training for Animal Research 14. Concepts and Practices of Animal Biosafety: ABSL-2 and ABSL-3 15. Aseptic Technique for Rodent Survival Surgery 16. Inhalation Anesthesia Systems for Rodents 17. Post-Procedure Care of Mice and Rats in Research: Minimizing Pain and Distress 18. Aquatic Animal Husbandry and Management 19. 8th Edition of the Guide for the Care and Use of Laboratory Animals (2011) 20. AVMA Guidelines for the Euthanasia of Animals: 2013 Edition