Contact and biographical details

Name and title of applicant (responsible person)

University / work address

Country

E-mail

Work telephone                       Work fax
   

Home address

Home telephone

I am 
Choose Teacher Student Campaigner Other (please specify)

My short CV

Other persons involved in the project

Name
Email

Name
Email

Name
Email

Project details

Category
Develop new alternative tool(s)
Choose Software Video Model, mannekin or simulator Other (please specify)  
Purchase of alternative tool(s)
Establish self-experimentation program
Establish body donation program
Establish clinical learning opportunities
Establish non-invasive field studies
Other (Please specify)

Summary of proposal

Detailed proposal

Description


Detailed budget 


Timescale for development, implementation, replacement and evaluation


Does the project involve animal cadavers or tissue, live animals or field studies to develop or establish the alternative tool or approach?

If animal cadavers and tissue, how do you propose to secure ethically-sourced animal cadavers and tissue in full accordance with the InterNICHE Policy on the Use of Animals and Alternatives in Education (read here)



If live animals, how do you propose to use or work with them in full accordance with the InterNICHE Policy on the Use of Animals and Alternatives in Education (read here)

If field studies, how do you propose to develop them in full accordance with the InterNICHE Policy on the Use of Animals and Alternatives in Education 
(read here)

Does the project involve human tissue? Please provide details


Will you use existing data or existing alternatives in the development of the alternative tool? Please provide details


If developing new software or video, will it be available to others as freeware (ie open source)?


As far as possible, please describe the existing situation in the course, department and faculty in terms of numbers and species of animals used, specific animal experiments and other harmful animal use


Can you guarantee replacement of harmful animal use resulting from the project? Please provide details in terms of numbers and species of animals, specific animal experiments and other harmful animal use


What is the strategy for implementation and replacement? What are the potential limitations to curricular change and how do you plan to overcome them? 


Will students have full access to the alternative upon implementation? 


How will you evaluate the impact of the project?


What will be the broader impact of the project, beyond replacement of harmful animal use and beyond the department or main area of implementation? How can this be optimised?


Will the project generate income? Please provide details


Further comments on the project

First referee

Name        
Email        
Telephone  
Address
        

Second referee

Name        
Email        
Telephone  
Address




Declaration

I have searched for existing alternative tools, including in the InterNICHE book 'from Guinea Pig to Computer Mouse' (2nd ed), before applying to the 2005 Humane Education Award

I have searched for government funds for this project before applying to the 2005 Humane Education Award. I have not received duplicate funds from government or other sources

I have read and understood the InterNICHE Policy on the Use of Animals and Alternatives in Education (read here)

I will provide InterNICHE with progress reports and an evaluation of the project

I understand that should I fail to complete the project as described I may be required to return the funds in full

InterNICHE reserves the right to publish information about successful projects.