Post visit report for Specialist Activities in Antarctica
Antarctic Act 1994
Antarctic Act 2013
Antarctic Regulations 1995/490 (as amended)
This form is to be used to report on Specialist Activities in Antarctica. Pursuant to the
provisions of the Antarctic Act 1994, the Antarctic Act 2013 and accompanying
Regulations, it is an offence to enter Antarctica without an appropriate permit.

If handwritten - block capitals please.

Complete Section 2 of this report if you have

o
undertaken a mineral resource activity;
o
killed, injured, captured, handled, molested or disturbed native mammals or
birds or to remove or potentially damaged native plants or invertebrates; or
where there is potential to damage habitats; and/or
o
introduced non-native animals, non-native plants or non-native microscopic
organisms.
Complete Section 3 of this report if you have
o entered an area designated as an Antarctic Specially Protected Area (ASPA),
Section 1 – Expedition details
1.1 Permit holder details
Name
Permit Number
Passport number
Address
International telephone no.
Email
1.2 Primary purpose of visit to Antarctica
Mineral resource
activity pursuant to
section 6 of the
Antarctic Act 1994
Other – please specify:
1.3
Disturbance of flora, fauna
and/or potential damage to
habitat
Pursuant to Section 7 of
the Antarctic Act 1994
Introduction of nonnative animals, plants
and microorganisms
pursuant to Section 8
of the Antarctic Act
1994
Eg ASPA
Arrival and departure dates – if more than one than trip please indicate below:
Dates of permit:
Trip 1
Trip 2
1.4
Name and general description of expedition
(e.g. sailing, climbing, leisure cruise etc)
1.5.1
Where did the activity take place
(e.g. Antarctic Peninsula, Shetland Islands, South Orkney Islands etc (state furthest south
latitude intended to visit)
1.6
Summary of scientific research undertaken and objectives of the collection or
Summary of Activity undertaken in the APSA
1.5
List of all persons who collected samples who were on the permit or persons
who entered the APSA
Full Name
Passport Number
Section 2 –Scientific Activity
Nationality
Complete if you have undertaken a mineral resource activity, killed, injured, captured,
handled, molested or disturbed native mammals or birds or to remove or potentially
damaged native plants or invertebrates; or where there is potential to damage
habitats; and/or introduced non-native animals, non-native plants or non-native
microscopic organisms
2.1
Dates and duration of sampling visit (s)
2.2
Method by which samples were taken (drilling, rock saw, hammer):
2.3
Measures taken during this visit to ensure compliance with the preliminary
assessment:
2.4:
Any departures from the provisions of the preliminary assessment & Permit
during this visit, noting dates, magnitudes and locations:
2.5
Observations of human effects on the sampling locations, distinguishing
between (a) those resulting from the visit and (b) those due to previous
visitors:
2.6
Descriptions and locations of markers, instrumentation or equipment
installed/removed, or any material released into the environment (noting how
long these are intended to remain in the Area and including GPS coordinates):
2.7
Any other comments:
3
Section 3 – Entry to an ASPA
Complete if you have entered an area designated as an Antarctic Specially Protected
Area (ASPA),
3.1
Measures taken during this visit to ensure compliance with the Management Plan:
3.2 Observations of human effects on the Area, distinguishing between those
resulting from the visit and those due to previous visitors:
3.3 Evaluation of whether the values for which the Area was designated are being
adequately protected:
3.4 Recommendations on further management measures needed to protect the values
of the Area, including location and appraisal of condition of structures, markers,
etc:
3.5 Recommendations on further management measures needed to improve bio
security:
3.6 Any other comment or information:
Signature
Signature of permit holder
Date
Official position (if applicable)
The post visit report form should be returned to the following:
Polar Regions Department
Overseas Territories Directorate
Foreign and Commonwealth Office
King Charles Street
London SW1A 2AH
polarregions@fco.gov.uk