Non-Human Primate Research Clearance Form

Researcher Information

Full Name Email Address Affiliation/Institution Position/Title

Project Details

Project Title Project Summary Research Objectives Research Site/Location Primate Species Involved Estimated Number of Animals Proposed Start Date Proposed End Date

Ethical Approvals

Ethics Committee Name Approval Number Approval Date Relevant Permits (list and attach as needed)

Animal Welfare & Biosafety

Description of Procedures Animal Housing/Handling Details Biosafety Measures

Signatures

Researcher Signature Date Supervisor/PI Signature Date