Research Booking Request Form Request your research space "*" indicates required fields Step 1 of 9 11% Researcher InformationName* First Last Email* 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 FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Invoicing AddressIf different from address above.Phone* 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?* Yes No Number of User Days granted*Number of Vehicle Days granted* Research InformationProject title*University/Institution associationAre permits required beyond the CNSC permit?* Yes No 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 Other Please provide information from selection above(Names, PAL#, organization providing bear guard etc.) Please attach copy of abstract or project information.*Max. file size: 12 MB. How many people from your team will be staying at the Centre?*Please provide names 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 RentalWill you require work space while on site?* Yes No 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?* Yes No 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?* Yes No Please list items and how you plan on disposing of them.* Will you require a vehicle while conducting research?* Yes No 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?* Yes No 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?* Yes No Will you be requesting use of CNSC firearms?* Yes No 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 InformationPlease provide email for invoicing, and specify if all researchers in this request will be invoiced together or separately.Additional commentsPlease 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 and something . Once you complete all pages and hit submit, you will be redirected to a confirmation page.
