Application for a Wildlife Scientific Collector's Authorization | Ministry of Natural Resources and Forestry

Instructions
Personal information contained on this form is collected under the authority of the Fish and Wildlife Conservation Act,1997 and will be used for the purpose of licensing, identification, enforcement, resource management and customer service surveys. Please direct further enquiries to the District Supervisor of the MNRF Issuing District.

All applicants must sign this form.

Fields marked with an asterisk (*) are mandatory.

Application

Corporation

Partnership

Individual

Other

Business Information

Business Identification Number (9-digit Business/HST Number, no spaces or dashes)

Legal Name (i.e. Corporation Number)*

Carrying on Business as (If different from Legal Name)

Applicant Information

Last Name*

First Name*

Middle Initial

Name of Business/Organization/Affiliation

Telephone Number

Ext.

Mobile Number

Email Address

Unit Number

Street Number*

Street Name*

City/Town/Municipality*

Province/State*

Country*

Postal/Zip Code*

Applicant Physical Address is same as above

Unit Number

Street Number*

Street Name*

City/Town/Municipality*

Province/State*

Country*

Postal/Zip Code*

Assistant

Purpose of Application

Education

Scientific Study

Other

(select all that apply)

Handle at the collection site for the purpose of collection samples, measurements or identification, and immediately release at the collection site

Relocate to temporary captivity off-site for a specific period of time, and then release at the collection site

Permanently keep in captivity

Relocate to an approved release location at or near the collection site in response to an imminent threat

Relocate to an approved release location within Ontario to support an approved translocation recovery plan

Translocate outside of Ontario to support an approved translocation recovery plan

Kill / lethal sample

Yes

No

Collection Information

Proposed activity Period From (yyyy/mm/dd) *

Collection Period End Date (yyyy/mm/dd)*

Collection

Attachments

Yes

No

Yes

No

Yes

No

Approved by applicant's animal care committee

Submitted with application for review by MNRF's Wildlife Animal Care Committee

Approved By MNRF's Wildlife Animal Care Committee

Yes

No

I have submitted all required reports from previous wildlife scientific collector's authorizations issued to me.*

Signature

I certify that the information provided in this application is true.

Signature

Name

Date of Application (yyyy/mm/dd)