Research on Biological Resources

Collection and Research on Protected Resources

Export on Biological and Protected Resources

Sale of Protected Resources

Research on Ethnobiological

Part 1   ORGANISATION PROFILE

              This part consists of information on the organization in which the applicant is affiliated to.

                  All fields MUST be completed by the applicant.

                  Commercial organizations are ALSO required to complete Attachment 1.

Name of Organization

Registered Address

Correspondence Address

Business Address

(if applicable)

Tel. No

Fax No.

E-mail

Website

Date of Establishment

Registration No.

Summary of the organization’s core business

Contact person for further information the organization

Part 2   INFORMATION ON THE APPLICANT AND RESEARCHER(S)

              This part must be completed by the applicant and EACH researcher/team        member involved in the project.

PHOTOGRAPH

Part 2a Personal Details

Name

Sex

Date of birth

Place of birth

Citizenship

IC/Passport No.

Correspondence Address

Permanent Address

Contact No.

(Office)

(Home)

(Mobile)

Fax No.

E-mail

Occupation

Designation

Organization/Institution

Department

Purpose of Research (Ph.D, M.Sc etc)

Field of Study

Role(s) of Applicant/Researcher

Names of accompanying persons

(accompanying members are not allowed to work or carry out research)

Citizenship

Age

Relationship

Occupation

Part 2b Supervision of Project

Name of Research Supervisor/Advisor

Address of Institution

Occupation

Designation

Area(s) of Expertise

Contact No.

          (Office)

(Home)

(Mobile)

Fax No.

E-mail

Part 2c  Researcher’s Educational Details & Professional Training

Names of

Institutions

Year

Qualifications

gained

Major fields

of Study

From   To

Part 2d            Related Research Experience in Sarawak

                  Provide brief description of related research experience conducted in Sarawak, if any.

                  Please include dates, description and details on publications related.

Part 2e  Related Research Experience outside Sarawak

                  Provide brief description of related research experience conducted outside Sarawak.

                  Please include dates, description and publication, if any.

Part 2f  Area(s) of Expertise & Special Qualifications

Part 3   PROJECT INFORMATION

                  This part needs to be completed only ONCE per application

Part 3a Project Title

Part 3b Project Classification

              e.g. botanical, zoological, microbiological, mycological, ethnobotanical, etc.

Part 3c  Project Abstract

Part 3d Project Background

1. rationale for the study

1. significance and benefits to Sarawak (in terms of the sustainable and environmentally sound use of biological diversity)

Part 3e  Project Objectives

(i)

(ii)

(iii)

Part 3f  Proposed Work Schedule

                  Please include Gantt Chart with expected starting and ending dates of research activities, dates of       submission of draft and final reports

Part 3g  Research Methodology

              This part is to be completed according to the outline as provided in the form.

(i) Type of biological resources to be collected in terms of species, parts of organism and quantities

(ii) Type of biological data to be collected

(iii) The time of executing or carrying out the collection activities

(iv) The place of executing or carrying out the collection activities

(v) The methods of executing or carrying out the collection activities

(vi) The local informants involved in the case of ethnobiological research

(vii) The use(s) of the collected biological resources

(viii) The plan for evaluation of the biological resources collected

(ix) The final destination of the biological resources collected

Part 3h Institution(s)

            Name(s) and address(es) of the Institution(s) in which the research/analysis will take place.

Part 3i  Expected Results and Programme Output

Part 3j  The anticipated and final destination of the information resulting from the access,        collection and research

Part 3k The anticipated uses of the information and end product

Part 3l  Financial Sponsor

  The financial sponsor must disclaim and waive all rights to any discovery or invention which may result from this project and any other activity pertaining to any biological resources of Sarawak.

Please complete Attachment 2.

(i) Name

(ii) Address

(iii) Amount

(iv) Terms and conditions of sponsorship

Part 3m           Permission To Enter Project Location

Please specify the permit(s) number and attach a copy of the permit(s) from the relevant authority.

For ethno-biological research please attach a copy of the Letter of Consent from the community leader.

Part 3n Local Collaborator (If applicable)

Collaborator is required to monitor, advise, facilitate and participate in the implementation of the research activities. Please complete Attachment 3.

For Official Use

Incomplete documentation

Re-apply with amendments

Action to be taken

Comments/Remarks

SHAREHOLDERS’ PROFILE

(You may use a separate sheet if the space below is insufficient)

Shareholder

Shareholder

Shareholder

Shareholder

BOARD OF DIRECTORS’ PROFILE

(You may use a separate sheet if the space below is insufficient)

Director

Director

Director

Director

Name

Address

Tel No.

Fax No.

Email address

IC/Passport No.

Citizenship

Date of birth

Place of birth

Position in the Organization

Appointment date

Qualifications

No. of Shares

KEY STAFF’S PROFILE

(You may use a separate sheet if the space below is insufficient)

Staff

Staff

Staff

Staff

Name

Address

Tel No.

Fax No.

Email address

IC/Passport No.

Race

Citizenship

Date of birth

Place of birth

Position in the Organization

Appointment date

Qualifications

No. of Shares