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Toad Dissection for Years 8 to 10 - Education Queensland

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Schools Repeating Application Form <strong>for</strong> <strong>Toad</strong> <strong>Dissection</strong> – <strong>Years</strong> 8-<strong>10</strong> 1/<strong>10</strong>/20<strong>10</strong><br />

Approval: Activity Continuous EDUCATION QUEENSLAND<br />

Declaration of authority <strong>to</strong> per<strong>for</strong>m this proposed animal use activity:<br />

<strong>Toad</strong> <strong>Dissection</strong> with students studying Science <strong>Years</strong> 8 <strong>to</strong> <strong>10</strong>.<br />

I, ___________________________, acknowledge that I am the teacher<br />

appointed/authorised teacher representative who will conduct this animal use<br />

activity at ____________________________________________________________.<br />

In that capacity I agree:<br />

(School/College name)<br />

a) <strong>to</strong> acquire and maintain a comprehensive understanding of the Australian Code of<br />

Practice <strong>for</strong> the Care and Use of Animals <strong>for</strong> Scientific Purposes prepared jointly by the<br />

NHMRC, CSIRO and ARMCANZ (the Scientific Use Code) and all Commonwealth and<br />

State Legislative and Codes of Practice requirements applicable <strong>to</strong> this Activity.<br />

b) all work in this activity that involves the use of animals will be carried out in compliance<br />

with the Scientific Use Code and all applicable Commonwealth and State Legislative<br />

requirements.<br />

c) no animal will be used in this activity except as described in this application.<br />

d) <strong>to</strong> accept, <strong>for</strong> the duration of this activity, full responsibility <strong>for</strong> the welfare of all animals<br />

used in this Activity.<br />

e) all staff members and students involved in animal use activities are competent <strong>to</strong><br />

per<strong>for</strong>m the necessary tasks with care and knowledge of their ethical and legal<br />

responsibilities.<br />

f) <strong>to</strong> put in place systems <strong>to</strong> ensure all personnel involved in the activity comply with all<br />

conditions imposed by the Animal Ethics Committee.<br />

g) all other school staff members who will be involved in this activity have read this<br />

application <strong>for</strong>m in the version submitted <strong>to</strong> the Animal Ethics Committee.<br />

Name: Name:<br />

Position: Principal<br />

Signature:<br />

Signature:<br />

Date: Date:<br />

Fax a signed copy of Section 1.6 (this page) <strong>to</strong>:<br />

Animal Ethics Officer Fax: (07) 3235 4379<br />

OR post a signed copy of Section 1.6 <strong>to</strong> the Animal Ethics Officer:<br />

<strong>Education</strong> House, PO Box 15033, City East Q 4002<br />

When a signed copy of this Declaration is held by the <strong>Education</strong><br />

<strong>Queensland</strong> Animal Ethics Officer your <strong>Education</strong> <strong>Queensland</strong> school<br />

has permission from <strong>Education</strong> <strong>Queensland</strong> <strong>to</strong> undertake <strong>to</strong>ad<br />

dissection with <strong>Years</strong> 8 <strong>to</strong> <strong>10</strong> students.<br />

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