Research Request Form Research Application Applicant Information* Prefix Dr.Prof.MissMr.Mrs.Ms.Prefer not to indicate First Last Contact informationPlease provide an address where you can receive BMSC communications for the foreseeable future.Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Email* Emergency ContactEmergency Contact Name* First Last Emergency Contact Phone*Emergency Contact Email* Research Request Details - Who's coming?Please list, below, personnel from your lab who will be conducting research at BMSC (including yourself if applicable). Include full name, email address, status (PI, Post Doc, Graduate Student, Assistant), arrival and departure dates for each lab member. Please include family members (ages of children in parentheses) who will be accompanying you, and their arrival and departure dates. This will help us to determine your housing requirements. ACCOMMODATIONS If you require on-site housing, you must phone (250-728-3301) or email Visitor Services to make a reservation. Please do this as soon as possible after you receive notice of your application approval. Click here for accommodation options.Research Group Size*Total number of researchers coming to BMSC in your research group. Please enter a number from 1 to 20.Researcher details*Please list each researchers name, email address, arrival and departure dates below. FirstLastEmailArrival DateDeparture DateStatus: PI, Research Associate, Post Doc, Grad Student, Undergrad, Research Tech, Family Member ANIMAL USEDoes your research require the use of animals? If 'Yes', review BMSC Animal Care policies and procedures, and contact the Animal Care Coordinator for details regarding your specific research issues.Animal Category* Vertebrates or Cephalopods Invertebrates No animals HAZARDOUS CHEMICALS / MATERIALSHazardous Chemicals*Does your research require the use of hazardous chemicals? If 'Yes', email a hazardous chemicals list to the Head of Research Services. Yes No Radioactive Materials*Does your research require the use of radioactive materials? If 'Yes', email a list of radioactive materials to the Head of Research Services. It is the responsibility of PI's to ensure their personnel have the appropriate training before using radioactive materials. Yes No BOATSBoat Use* Do you plan to use BMSC boats for research purposes? If "Yes", provide details below Yes No For use of BMSC 14' and 16' Copes, operators must have: Pleasure Craft Operator's Card (PCOC); and Valid, in-person, 16-hour First Aid certification with CPR-C (equivalent to Marine Basic First-Aid) A marine radio operators certificate (ROC-M) is technically required for users of VHF radios in Canada, however anyone can use such radios in the event of an emergency. An ROC-M is strongly advised. For use of BMSC Raider and skiffs, operators must have: Small Vessels Operators Permit (SVOP); and MED-A3 (now called Small Domestic Vessel Basic Safety) ROC-M Current certification in Marine Basic First Aid with CPR-C, or an equivalent in-person, 16 hour first aid course recognized by a province or territory Boating experience is recommended but not necessary; training may be provided upon arrival if requested. CertificationsI would like to operate boats and presently have the necessary certifications. Yes No Researchers holding PCOC & First Aid certificationsFirstLastPCOC or SVOP numberFirst Aid CertificationFirst Aid certifcation expiry dateROC-M # - if applicableMED-A3 # (now called Small Domestic Vessel Basic Safety) - if applicable I will obtain the necessary certifications prior to arriving at BMSCI will obtain the necessary certifications prior to arriving at BMSC Yes No SCUBADo you plan to use SCUBA for research purposes?* Yes No If you intend to dive at BMSC, consult the BMSC website on qualifying as a Scientific Diver at BMSC, review our Scientific Diving policies and procedures, and contact the Dive & Safety Officer. Dive collections can be made on your behalf. Consult the research fees and contact the DSO for further information.Further DetailsUse this area to provide further details about your research requirements at the BMSC.File Submission ChecklistPlease forward the following information via email to the Head of Research Services.1. Research User Agreement Form Download, sign and email the Research User Agreement Form to the Head of Research Services.2. Research Description Please provide a short description of your research interests and outline in brief your plans for work to be carried out at BMSC. In particular, it is helpful to know your short and long term objectives.3. Publications List Please provide a list of peer-reviewed publications generated by your lab resulting from research conducted at BMSC, for the last five years.4. Alumni List Please provide a list of names of your BMSC Alumni students (undergraduates, graduate students, and PDFs) that have graduated, with their degree and year, including any publication details.By submitting this form, I certify that the above information is complete and accurate.By submitting this form, I certify that the above information is complete and accurate. I acknowledge that failure to disclose complete and accurate information may result in denial of admission or dismissal from BMSC. I acknowledge that physical injury and death are risks inherent in the use of these facilities, and I assume all associated risks and I agree not to claim against BMSC for those risks. I agree to hold BMSC harmless from any and all injuries, damages and liabilities that may occur in the course of my visit, except for negligent acts or omissions of BMSC or its employees, students or agents acting in the scope of their duties. By submitting this form, I agree to follow the Research Policy rules at BMSC, which is available on our website and from the Head of Research Services.CAPTCHA