Wildlife Research Application

Principal Investigator

First Name

Middle Initial

Last Name

Address

Street Address

City

State

Your E-Mail Address

Phone Number

Organization Information

Affiliation/Sponsoring Organization

Relationship to Affiliation/Sponsoring Organization (staff, professor, student, etc.)

Resumes

CV or Resume Upload

Is CV or resume attached for Principal Investigator and all Sub-permittees? Please note there is a 1.9 mb file size upload limit.

CV or Resume Upload - 2

Is CV or resume attached for Principal Investigator and all Sub-permittees? Please note there is a 1.9 mb file size upload limit.

CV or Resume Upload - 3

Is CV or resume attached for Principal Investigator and all Sub-permittees? Please note there is a 1.9 mb file size upload limit.

Permits

State and/or Federal Permits

Are State and/or Federal permits attached? Please note there is a 1.9 mb file upload limit.

State and/or Federal Permits - 2

Are State and/or Federal permits attached? Please note there is a 1.9 mb file upload limit.

Assurance of Animal Care Form

For research involving vertebrates, upload the Assurance of Animal Care Form or an approval from an Institutional Animal Care and Use Committee form here. Please note there is a 1.9 mb file size upload limit.

Assistants/Subcontractors/Sub-permittees List known assistants/subcontractors/sub-permittees

Name

Address

Phone Number

Name

Address

Phone Number

Project Information

Project Title

Attach Research Proposal

Please note there is a 1.9 mb file size upload limit.

Describe the Project

Describe the project and identify timing, activity frequency, and how the project is expected to proceed.

Identify Locations & Maps

Identify location(s) and attach a map for the project area: (GPS location(s) preferred).

Attach a Map for the Project Area

Please note there is a 2.9 mb upload limit.

Identify What's Being Studied

Identify all plant and wildlife species and/or habitats being studied, and types of specimen collections to be taken and/or all data to be collected during the proposed project.

Project Purpose/Hypothesis

Ecological Benefits

Describe the expected ecological benefits of the research project.

Project History

Briefly describe the project history and context of the research project.

Project Relationship

Briefly describe the project’s relationship to other research projects either known of or conducted by the applicant.

Specimen Collections

Identify the types and requested number of specimen collections to be taken or captured and released and/or all data to be collected during the proposed project.

Cooperators and Institutions

List other cooperators and institutions involved in the project.

Timeline

Generally, identify the anticipated timeline for analysis, write-up, and report/publication.

Permit Information

Federal, State, or Tribal Permits List and attach copies of any other Federal, State, or Tribal permits if required.

Permit Type

Permit Number

Expiration Date

Upload Permit

Please note there is a 2.9 mb file size limit.

Permit Type

Permit Number

Expiration Date

Upload Permit

Please note there is a 2.9 mb file size limit.

Disclaimer and Signature

Disclaimer

By checking the box, I certify that my answers are true and complete to the best of my knowledge, that I will abide by and ensure that all Sub-permittees abide by the terms and conditions of any issued permit, including all laws applicable to the permitted activity and the attached General Conditions and Requirements.

Date

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