Researcher-in-Residence Program Application

First Name *

Middle Initial

Last Name *

Email *

Date of Birth (mm/dd/yyyy) *

Gender

Nationality

Street Address

Apartment/Unit Number

City

ZIP / Postal Code

State / Province

Country

Do you require any mobility assistance when ascending/descending a flight of stairs or to climb in/out of a Zodiac?

Yes

If more than one, list trips in order of preference.

B.1.Why do you want to conduct a project on this voyage? *

B.2. Describe the purpose and background rationale for the proposed project, as well as any hypotheses and/or research question to be examined.

B.3. Affiliation (name of university/college/organization or independent)

B.4. Indicate the location(s) where the project/research will be conducted (aboard ship, in communities, etc.)

B.5. Describe in detail and sequentially how you will carry out your project.

B.6. What instruments or equipment will be used? Describe how/where you will use each of them.

B.7. What is the proposed final product from your project?

B.8. Which of the United Nations Sustainable Development Goals does your project align with?

C.1. Does your project involve human participants?

No, please skip section C questions

Yes, please complete below questions

C.2. Does the proposal involve the trip's guests?

Yes

C.3.2. If yes, please explain

C.3.3. If yes, please list the permits that are required to involve stakeholders.

C.4. Are you using partial disclosure or deception (i.e. the participant may not know that they are part of a project until it is over or is not informed of the true purpose of the research in advance)?

Yes

C.5. Please describe how you will recruit research participants.

C.6. In what language(s) will the research be conducted?

Does your project involve specimen?

Yes, please complete below questions

No, please skip section D questions

Does your project involve collection of specimen?

Yes

List any potential adverse effects that your project may have on the specimen.

Please list the permits that are required.

E.1. Adventure Canada would also like to be able to promote the type of science and the specific projects that are taking place onboard the vessel though its website, social media, and any other outlets it deems appropriate.

I agree

I disagree

E.2. Adventure Canada would like to be notified on studies or reports published so that we can share the results with our passengers and constituents, to help promote the knowledge base we are helping to build.

Adventure Canada does not expect a right of first refusal, a preview approval of any publications, ownership nor to set direction of the research.

I agree

I disagree

Please print your name: *

Date (mm/dd/yyyy) *

I read and agree to Adventure Canada’s Privacy Policy*