APPLICATION FOR A LABORATORY ANIMALS LTD BURSARY ( 6/16) Application number

LAL is a company which applies all its resources to the advancement of public education in laboratory animal science, technology and welfare. Its main business is to edit and publish Laboratory Animals, the international journal of laboratory animal science and welfare. Each year financial support is provided for a wide range of activities, including funding for events or projects organised by applicants that conform to the goal of the company, or for applicants to attend at training courses.

Large Projects (bursary value over five thousand GB Pounds): Applications must be submitted at least four months before the proposed start date of the project and will be subjected to approval by the LAL Council of Management.

Deadlines for applications are 31st March and 30th September annually

- Applications submitted for the 31st of March deadline are for activities that will take place between 30 th April of the same year and 30th April of the following year.

- Applications submitted for the 30th of September deadline are for activities that will take place between 31st October of the same year and 31st October of the following year.

To apply for funding this form should be completed and returned to the email [email protected]

GENERAL INFORMATION a) NAME OF THE APPLICANT AND FULL TITLE

(please underline your main surname) b) APPLICATION SUBMISSION DATE c) APPLICATION TITLE (e.g. “Attend a course in xxxx”; “Speakers at Congress: xxx”, “Translation of xxx”, etc.): d) TOTAL FUNDING REQUESTED (in Euros) e) DATE/S OF THE ACTIVITY: PERSONAL INFORMATION f) ADDRESS FOR CORRESPONDENCE g) NATIONALITY h) EMAIL ADDRESS i) TELEPHONE NUMBER j) FAX NUMBER k) ARE YOU MEMBER OF CONSTITUENT LABORATORY ANIMAL SCIENCE ASSOCIATION? (Please indicate which: LASA, GV-SOLAS, ILAF, NVP, SGV, SECAL, SPCAL, ESLAV, LAVA, AFSTAL) l) YOUR PRESENT EMPLOYMENT (Name and address of Institute or Department, position held, principal responsibilities) DESCRIPTION OF THE ACTIVITY FOR WHICH YOU ARE REQUESTING FUNDING PROJECT m) Description of the project to be supported (attach further details if necessary. For

symposia please provide location and date and include a copy of the announcement and programme). COURSE ATTENDANCE n) Name and location of Institute(s) and course(s) that you wish to attend o) Is the course or training activity accredited and

if so by whom? p) Reasons for the selection of this particular

Institute(s) and course(s) q) MAIN GOAL OF THE ACTIVITY r) HOW WILL ANIMAL WELFARE BENEFIT FROM THE ACTIVITY FUNDED AND HOW WILL THE

RESULTS ACQUIRED BE SHARED WITH YOUR COMMUNITY/PEERS s) BUDGET: Provide a breakdown of the budget, e.g. running costs for symposia, expenses associated with attending a course. t) INDICATE OTHER SOURCES OF FUNDING IF

EXIST: u) IF YOU HAVE RECEIVED OR APPLIED FOR FUNDING PREVIOUSLY FROM LABORATORY ANIMALS LTD PLEASE GIVE DETAILS: OTHER NECESSSARY INFORMATION v) YOUR CAREER TO DATE (Courses attended,

qualifications gained, awards, positions held) w) OTHER EXPERIENCE x) REFERENCE (Please give the name and address of at least one referee who may be approached on your behalf). CANDIDATE’S DECLARATION The foregoing statements are accurate to the best of my knowledge and belief SIGNATURE DATE

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