AEC Membership Application Form

Animal Ethics Committee Membership Application Form

Thank you for showing interest in membership on the CDU Animal Ethics Committee (AEC). Please note the following responsbilites and requirements of AEC membership:

The AEC meets eight times per year. Meetings are of approximately four hours duration and occur on Wednesday mornings. Members should aim to attend 5 meetings per year or more.
The AEC undertakes a number of inspections of animal facilities. These facilities are in various locations. AEC members are requested to attend inspections. AEC members should aim to attend one inspection per year.
AEC members should be prepared to spend about 10-12 hours per meeting to committee duties (meeting attendance and pre-reading of papers). For category C and D members, this includes occasionally sitting on the Executive Committee which functions to review items via email/online in between meetings.
AEC members require reasonable computer skills, an ability to learn new computer systems, as well as access to your own computer.
AEC members are appointed for a term of three years.

1. Understanding what membership category you may be

The following questions help us determine what membership category you may qualify for. Membership categories and the required criteria for each category are outlined in the Australian code for the care and use of animals for scientific purposes (the Code) and are as outined below:

Category A—a person with qualifications in veterinary science that are recognised for registration as a veterinary surgeon in Australia, and with experience relevant to the institution’s activities or the ability to acquire relevant knowledge (wildlife, aquaculture, livestock).

Category B—a suitably qualified person with substantial and recent experience in the use of animals for scientific purposes relevant to the institution and the business of the AEC (wildlife, aquaculture, livestock). This must include possession of a higher degree in research or equivalent experience.

Category C—a person with demonstrable commitment to, and established experience in, furthering the welfare of animals, who is not employed by or otherwise associated with the institution, and who is not currently involved in the care and use of animals for scientific purposes. Veterinarians with specific animal welfare interest and experience may meet the requirements of this category. While not representing an animal welfare organisation, the person should, where possible, be selected on the basis of active membership of, and endorsement by, such an organisation.

Category D—a person not employed by or associated with an organisation using the CDU AEC (Charles Darwin University, certain NT Government departments, ecological consultants) and who has never been involved in the use of animals in scientific or teaching activities, either in their employment or beyond their undergraduate education. Category D members should be viewed by the wider community as bringing a completely independent view to the AEC, and must not fit the requirements of any other category.

Category E—a person responsible for the routine care of animals used for scientific purposes or with skills and background of value to the AEC.

Category A - Veterinarian

Do you have a degree in veterinary science? *

YesNo

If Yes, please provide additional comments *

Is your degree recognised for registration in Australia? *

YesNo

If No, please provide additional comments *

Do you have experience relevant to the species under the AEC purview? (wildlife, cattle, aquaculture, feral animals) *

YesNo

or

Are you familiar with biology and characteristics of the species used? Please outline under Comments *

YesNo

If Yes, please provide any additional comments on either the above 2 selections *

Category B - Researcher / Teacher

Do you have recent relevant research or teaching experience (within 3 years) in a biological or agricultural field? *

YesNo

If Yes, please provide additional comments *

Is your experience relevant to the species used by the organisation? (wildlife, cattle, aquaculture, feral animals) *

YesNo

If Yes, please provide additional comments *

Do you possess a higher degree? *

YesNo

or

Can you provide a brief statement of your recent research/teaching experience Please outline under Comments *

YesNo

If Yes, please provide any additional comments on either the above 2 selections *

Category C - Animal Welfare Member

Do you have a demonstrable commitment to and established experience in furthering animal welfare? *

YesNo

If Yes, please provide additional comments *

Are you currently employed or associated with an organisation using the AEC? (CDU, NT Government Department, fauna consultants) *

YesNo

If Yes, please provide additional comments *

Are you currently involved with the care, supply or use of animals for research/teaching? *

YesNo

If Yes, please provide additional comments *

Have you been nomination by an animal welfare organisation for this role on the AEC? If so, which organisation? *

YesNo

If Yes, please provide additional comments *

Are you a member of an animal welfare or wildlife care organisation? If so, which organisation? *

YesNo

If Yes, please provide additional comments *

Do you have any previous involvement with the care, supply or use of animals for research/teaching? *

YesNo

If Yes, please provide additional comments *

Category D - Independent Member (Layperson)

Are you employed by or associated with an organisation using the AEC? (Charles Darwin University, NT Government Department, fauna survey consultants) *

YesNo

If Yes, please provide additional comments *

Have you ever been involved in the use of animals in science or teaching, beyond undergraduate education? *

YesNo

If Yes, please provide additional comments *

Do you fit the requirements of any other category? *

YesNo

If Yes, please provide additional comments *

Do you have a background in biological sciences? *

YesNo

If Yes, please provide additional comments *

Category E - Animal Carer

Are you employed or engaged by an organisation using the AEC? (Charles Darwin University, NT Government Department, fauna survey consultants) *

YesNo

If Yes, please provide additional comments *

Are you responsible for the day-to-day care of animals used in research or teaching? *

YesNo

If Yes, please provide additional comments *

Do you have a detailed knowledge of the housing, care, husbandry or management of populations of animals used in research or teaching? *

YesNo

If Yes, please provide additional comments *

2. Which Category are you applying for?

Which membership category are you applying for? *Please select all that apply if you fit the requirements of more than one category

3. Details of applicant and signature

Title *

Full name *

Occupation/Position *

Department/Organisation *

Address *

Street address *

City *

State *

Postcode *

Email address: *

Phone number: *

Do you have any conflicts of interests to be declared? *

Do you have any objections to the care, supply or use of animals for research/teaching? *

Are you currently studying? *

YesNo

if Yes, Please advise where you are studying *

Please advise of any relationships to CDU or other organisations that may use animals and/or use the services of the CDU AEC. *

Have you ever been convicted of an animal cruelty offence; had an animal research approval suspended or terminated; or undergone disciplinary action by an employer regarding the care and handling or animals? *

YesNo

If yes, please provide details. *

I am interested in applying for membership on the Charles Darwin University Animal Ethics Committee and can meet the responsbilities and requirments of the committee as outlined at the start of the form

Signature *

Clear

Date: *

Attachments:

Please attach a copy of your CV *

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