Edward H. Bean Award
2015
A P P L I C A T I O N
All applications are due by close of business on June 1, 2015, and must be compiled into one PDF file.
Please make sure the file name reflects both the award name and the institution. Abbreviations are fine.
AZA has contracted with WEBCARGO to provide a quick and easy way for you to submit your application.
Please submit your application using this link:
https://www.webcargo.net/request/index/id/5860789/dp/0hx6wVPdIBVUnLusCc
WEBCARGO allows you to send large files via email, without the need to reduce their size. There is no need
to sign up, nothing to install and nothing to download. All deliveries are encrypted so security is not an issue
and WEBCARGO sends confirmation when your file is received. The upload speed varies depending on your
Internet Service Provider and the size of your file so you may need to be patient. Please send a note to
support.webcargo.net if you need assistance with the upload.
Questions? Please contact Barbara Pueschel (bpueschel@aza.org; 301-244-3326).
See 2015 Edward H. Bean Award Guidelines for information about completing this application.
A. CANDIDATE
Vernacular name:
Scientific name (include subspecies if applicable and known):
B. APPLICANT
Institution Name:
Address:
Name of Director:
Signature of Director:
C. BASIC INFORMATION PERTAINING TO PROGRAM
Date program began:
Reason program was initiated:
Gestation/Incubation period (if known):
Is progeny still in collection?
Yes
If not, provide date and disposition:
No
Date:
Disposition:
Total number of specimens in breeding group:
Length of time specimens of this species/subspecies has been maintained in collection:
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Was this a first birth/hatching of this species/subspecies in the collection?
Yes
No
Which generation does the most recent birth/hatching represent?
Provide complete records documenting the management and propagation history of the species.
(e.g., ISIS Historical Inventory report, Reproduction History report, etc.)
Copy attached.
Has this program previously been submitted for an AZA award?
If yes, did it win an award?
Yes
Yes
No
No
D. ACQUISITION/DISPOSITION:
Parentage of original animals in the program or animals brought into the program
Male Parent
Female Parent
Wild or zoo/aquarium born/hatched
Acquisition date, if from an outside source
Age at acquisition or birth/hatching date (if known)
Source
E. MANAGEMENT AND HUSBANDRY
Please include a description of the history of this species/subspecies in the collection and any prior
propagation efforts. Also, explain any management and husbandry techniques utilized to stimulate
and ensure this breeding success.
Additional information such as behavioral observations, nutritional data, or bibliography of
publications (in print or in the process of being published) will assist the committee in its
deliberations. Please consult the guidelines.
Impact of program: (applicability to other species, impact on wild counterparts)
Can the program be, or has it been duplicated at other institutions?
Has the program benefited species/subspecies anywhere else?
F. IMAGE—one digital image that illustrates the program—to be used during the AZA Annual
Conference Awards Ceremony.
G. PARTICIPATION
Name and institution of those to be acknowledged for their participation in the program:
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H. COLLABORATION (if applicable)
Name(s) and AZA membership number(s) of collaborating institution(s):
I. SUBMITTER
The SUBMITTER is that person responsible for the contents of the entry. Failure to provide an
electronic signature on the designated line will constitute an incomplete application.
Name:
Title:
Signature:
Date:
E-mail address:
J. NEWS RELEASE FORM
Submit the News Release Form (available at http://www.aza.org/honors-awards/) with the
application and also email the form as a WORD document to Barbara Pueschel:
bpueschel@aza.org
K. WINNER’S RELEASE: HELP YOUR FELLOW MEMBERS!
If yours is the winning application, would you be willing to have it posted on the AZA website?
Yes
No
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