Your Details Title MrMrsMsMissMxDrOther Name Your full legal name Email Address Phone Number Residential Address Role / Position Research Institution Production Company Project Project Title Project Aims & Objectives Is this a new project or part of an ongoing project? Details of project timeframe Dates when access required Include the start and end dates Locations Detailed outline of locations (with approximate coordinates) of study area and/or sample sites for the research project. Methodology Methodology Please provide details of the methodology of the project. This should include: target species, fauna and flora survey/sampling methodology, firearm or poison use and any plans to undertake bioprospecting activities. Ethics Commitee Has the project received approval from an authorized ethics committee? Yes Effects on the physical environment Will this research affect the physical environment? If yes, how do you plan to mitigate these impacts? Community Visits Will you visit any communities during the research? If yes, please list which communities and how often you anticipate visiting each community. Logistics Transport Arrangements What transportation arrangements will you make for your time on the island? Logistical Support Do you require any logistical (or other) support from the ALSM unit? Please detail requirements. Aboriginal Culture & Intellectual Property Rights Usage of local indigenous knowledge Does the project seek to use local indigenous knowledge? How will you ensure indigenous knowledge gathered during the project remains confidential? What provisions in the research proposal ensure Aboriginal cultural and intellectual property rights are protected? Media Recording Do you plan to include photography, film, sound recording or other forms of media as part of your project? Please describe. Usage of flora or fauna Do you intend to use flora or fauna genetic material? Yes Aboriginal Participation Traditional landowners engagement How do you propose to engage traditional landowners in this project? Traditional owners knowledge and participation Does your project require the knowledge and participation of traditional owners? If so, how will individuals be compensated for their services? Benefits for the communities/traditional owners What types of monetary or non-monetary benefits will be provided to the communities/traditional owners for the use of their land, waters or knowledge? E.g. skills and training, awareness and education, capacity development. Ranger skill/knowledge development Does your research provide opportunities for ranger skill/knowledge development? If yes, describe. Outcomes Research Outcomes How will the research outcomes inform land and/or sea management activities undertaken within the Anindilyakwa IPA? Outcomes Presentation Please provide details of how you plan to present the progress and outcomes of the project to traditional owners and the ALSM unit. Agreement Other Details Please detail any other relevant information about your project that has not been covered above Agreement By entering my name below, I agree that all information provided is present and correct and that, if granted access, I will comply with the rules of the Anindilyakwa Land Council and respect the wishes of Traditional Owners. If an error occurs during form validation you will not be charged. You will only be charged when form submit is completed without errors.