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COVID Update:

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Recherche

Booking Request Form

Réservez votre espace de recherche

« * » indique les champs obligatoires

Étape 1 de 9

11%

Informations sur le chercheur

Prénom*

Prénom Nom

Email*

Adresse*

Adresse postale Adresse ligne 2 Ville État / Province / Région ZIP / Code postal Pays

Adresse de facturation

Si différente de l'adresse ci-dessus.

Téléphone*

Requested start date*

DD slash MM slash YYYY

Requested end date*

DD slash MM slash YYYY

Are you a recipient of the CNSC Northern Research Fund?*

Oui

Non

Number of User Days granted*

Number of Vehicle Days granted*

Research Information

Project title*

University/Institution association

Are permits required beyond the CNSC permit?*

Oui

Non

Type of permit(s)*

Permit ID(s)

Has this/have these permit(s) been applied for or obtained?*

Applied for

Obtained

Neither

Wildlife Safety Plan

A member of my group has their Canadian Firearms License, and we will provide our own wildlife guard

I plan to hire a wildlife guard for our fieldwork

I will not be going out into the field

Autre

Please provide information from selection above

(Names, PAL#, organization providing bear guard etc.)

Please attach copy of abstract or project information.*

Taille maximum des fichiers : 64 MB.

How many people from your team will be staying at the Centre?*

Veuillez saisir un nombre entre 1 et 50.

Please provide names of your team.

To the best of your knowledge, please indicate the number of people of each gender on your team.*

This helps us determine room assignments.

Equipment Rental

Will you require work space while on site?*

Oui

Non

Start date required for work space*

DD slash MM slash YYYY

End date required for work space*

DD slash MM slash YYYY

How much work space do you require?*

Number of seats, measured area, etc.

Will you be requiring any other lab or research equipment?*

Oui

Non

What other equipment will you require?*

Start date for required equipment*

DD slash MM slash YYYY

End date for required equipment*

DD slash MM slash YYYY

Will you using or disposing any potential biohazards or chemical hazards?*

Oui

Non

Please list items and how you plan on disposing of them.*

Will you require a vehicle while conducting research?*

Oui

Non

What type of vehicle will you require?*

Start date for required vehicle*

DD slash MM slash YYYY

End date for required vehicle*

DD slash MM slash YYYY

Will you be using a firearm while conducting research at the CNSC?*

Oui

Non

Please confirm that you have read our firearm use policy.*

I have read the Churchill Northern Studies Centre firearm use policy and agree to the terms.

I confirm that I have read the firearm use policy.

Will you be storing your own firearm while on site?*

Oui

Non

Will you be requesting use of CNSC firearms?*

Oui

Non

How many firearms will you be requesting?*

Start date for requested firearm(s)*

DD slash MM slash YYYY

End date for requested firearm(s)*

DD slash MM slash YYYY

Invoicing Information

Please provide email for invoicing, and specify if all researchers in this request will be invoiced together or separately.

Additional comments

Please provide any other relevant information about your requirements.

All studies are review by our science department. Any studies in question are reviewed in more detail through a review panel .

Une fois que vous aurez complété toutes les pages et cliqué sur « soumettre », vous serez redirigé vers une page de confirmation.

P. O. Box 610
Churchill, Manitoba, Canada
R0B 0E0

Téléphone: 204-675-2307
Fax: 204-675-2139
Email: [email protected]

CBN: 100966175RR0001

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