Form 4.1C: Animals – Instructions 1. Form 4.1C This form certifies that a project involving the use of vertebrate animals, Cephalopods, embryos or animal tissue is in full compliance with Policy 4.2.2 Use of Vertebrate Animals and Cephalopods in Research. 2.
Documents The Research Proposal must be available to the Adult Supervisor, along with form 4.1C.
3. Instructions for Participants in the Regional Science Fair a. Fill in Form 4.1C (see next page) on a computer, not by hand. b. Print the completed Form 4.1C, and then get it signed with all the required signatures. c. Make a paper copy of this completed and signed form. d. Store the original signed copy of form 4.1C in a safe place. e. Take the copy of signed form 4.1C to your District Science Fair.
4 August 2012
Youth Science Canada Form 4.1 C Vertebrate Animals and Cephalopods Approval
Form 4.1C: Vertebrate Animals and Cephalopods Approval This form certifies that a project involving the use of vertebrate animals, Cephalopods, animal embryos, or animal tissues, is in compliance with Policy 4.2.2 Use of Vertebrate Animals and Cephalopods in Research. District Project Title First Name
Last Name
Email
Phone
Student 1 Student 2 Chair, RSF1 Chief Judge, RSF Adult Supervisor Scientific Supervisor Safety and Ethics Officer This project involves:
Vertebrate Animals
Cephalopods
Animal Tissue
Request for Ethics Approval I have visited and understood the web site of the YSC National Ethics and Safety Committee http://youthscience.ca/node/835 I have read and understood Policy 4.2.2 Use of Vertebrate Animals and Cephalopods in Research
Signed - Student 1
Date
Signed - Student 2
Date
Signed – Adult Supervisor
Date
Adult Supervisor Affiliation
Signed – Scientific Supervisor
Date
Scientific Supervisor Affiliation
Ethics Approval I certify that this project involving the use of animals is in full compliance with Policy 4.2.2 Use of Vertebrate Animals and Cephalopods in Research, and that it is eligible for the District Science Fair. Signed – Safety and Ethics Officer 1Or
Date
designate.
4 August 2012
Youth Science Canada Form 4.1 C Vertebrate Animals and Cephalopods Approval
Form 4.1C - Vertebrate Animals and Cephalopods Approval.pdf ...
Page 1 of 2. 4 August 2012 Youth Science Canada Form 4.1 C Vertebrate Animals and Cephalopods Approval. Form 4.1C: Animals â Instructions. 1. Form 4.1C. This form certifies that a project involving the use of vertebrate animals, Cephalopods, embryos or. animal tissue is in full compliance with Policy 4.2.2 Use of ...
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