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Place  X in Appropriate Box Below: PI Info Principal Investigator(s)( Faculty( Staff( Student( External FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      UNE Department: FORMTEXT       FORMTEXT      UNE Mailing Address*: FORMTEXT      UNE Telephone*: FORMTEXT      Fax: FORMTEXT      Email: FORMTEXT      **If external submission, please use U.S. mailing address B. CHANGES IN PERSONNEL: 1. Change in personnel or personnel roles. 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PRINCIPAL INVESTIGATOR(S) SIGNATURE & CERTIFICATIONS 1. I certify that I have completed the institutionally required (CITI) investigator training course or attended the institutionally conducted animal use refresher course (required every 3 years). 2. I certify that the individuals listed in Section B. are authorized to conduct procedures involving animals under this proposal, have attended the institutionally required training course, and received training in: the biology, handling, and care of this species; aseptic surgical methods and techniques (if necessary); the concept, availability, and use of research or testing methods that limit the use of animals or minimize distress; the proper use of anesthetics, analgesics, and tranquilizers (if necessary); and procedures for reporting animal welfare concerns. 3. I certify that I will obtain approval from the IACUC before initiating any changes in this study. 4. I certify that I will notify the IACUC regarding any unexpected study results that impact the animals or personnel. Any unanticipated pain or distress, morbidity or mortality will be reported to the attending veterinarian and the IACUC. 5. I certify that I am familiar with and will comply with all pertinent institutional, state, and federal rules and policies. Principal Investigator(s): Print Name:  FORMTEXT      Signature: Date:  FORMTEXT      Print Name:  FORMTEXT      Signature: Date:  FORMTEXT      Print Name:  FORMTEXT      Signature: Date:  FORMTEXT       Concurrences: * Required for Student Research * Faculty Supervisor/Mentor required for all student PI submissions: Print Faculty Name:  FORMTEXT      Faculty Signature:Date:  FORMTEXT        Send an electronic copy to:  HYPERLINK "mailto:iacuc@une.edu" iacuc@une.edu. 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