Academia Sinica Institute of Biomedical Science Laboratory Animal Facility
APPLICATION TO BREED LABORATORY ANIMALS
I.
1) Full Species/stock Name of breeding animals
a.
b.
c.
2) State the usage and the rationale for animal breeding (including commercial availability)
3) Projected number of animals
a. ______ /month, a total of _________ /year (gender:  ♂. ♀,  either)
b. ______ /month, a total of _________ /year (gender:  ♂. ♀,  either)
c. ______ /month, a total of _________ /year (gender:  ♂. ♀,  either)
4) Projected use period:
From _______/_________ To ___________/__________ (yr/mo.)
5) Indicate, if any, unique physiological conditions, obstacles to breeding, and special
nutritional requirements for the breeding animals. (Please attach original documents
concerning the characteristics of the breeding animals)
6) Indicate method of breeding: (inbred, random bred or hybrid…)
7) Indicate the source of breeding pair:



Provided by the applicant
Recommended source
To be determined by LAF
P.I. Signature
__________________________________________________
Application Date:
_____________________________________(yr/mm/dd)
II. COMMENTS OF LABORATORY ANIMAL FACILITY
III. COMMENTS OF THE LABORATORY ANIMAL FACILITY COMMITTEE