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Animal
Subjects
Fort Hays State University
Application For Approval To Use Vertebrate
Animals In Research And Training
This application should be attached to the project
proposal or description and submitted to the chair,
Institutional Animal Care and Use Committee.
1. Name of principal Investigator
(s) or Responsible Individual (s): __________
_________________________________________________________________
_________________________________________________________________
2. Departmental Affiliation: _________________________________________
3. Title Of Project: __________________________________________________
4. Funding Agency (if applicable) _____________________________________
5. On a separate sheet, please describe how your activity
conforms with the requirements listed in E.2., a through g, of the
Fort Hays State University Assurance Policy for those requirements
which are relevant and not described fully in your project
proposed.
6. Statement Of Agreement: I have acquainted
myself with the Federal Regulations and University Policy regarding
the care and use of animals in research and training activities
and will be cleared through the Institutional Animal Care and Use
Committee.
__________________________________________________
Applicant
__________________________________________________
Date
(Signature of Major Professor When Appropriate)
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