Researcher-in-Residence Program Application

First Name *

M.I.

Last Name *

Email *

Date of Birth (mm/dd/yyyy) *

Gender

Nationality

Address

Street Address

Apartment/Unit Number

City

State/Province

Postal/Zip Code

Country

Do you have any physical limitations that would impede hiking or moving in and out of a Zodiac?

YesNo

Please indicate the trip(s) you would like to apply for. *

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

Section B: General Project Proposal

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. Project Affiliation (name of university/college/organization or indicate if project is 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/equipment will be used. Describe how/where you will use each of the them.

B.7. Intention of results/final product from proposed project.

B.8. Please explain the perceived interest to the public at large.

Section C: Projects Involving Human Participants

C.1. Does your project involve human participants?

No, please skip section C questionsYes, please complete below questions

C.2. Does the proposal involve our passengers?

YesNo

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)?

YesNo

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

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

Section D: Projects Involving Specimen

Does your project involve specimen?

Yes, please complete below questionsNo, please skip section D questions

Does your project involve collection of specimen?

YesNo

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

Please list the permits that are required.

Section E: Signature

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 agreeI 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 agreeI disagree

Signature, Please print your name. *

Date (mm/dd/yyyy) *

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