ࡱ> HJG_ bjbj 785\5\B B vvvvvQQQ       $^ #/QQ/vvDLLLvv L LLuv`?]Z0,#j##4Q0"LQQQ//0QQQ#QQQQQQQQQB > : AMMENDMENT APPLICATION FOR APPROVAL OF THE USE OF VERTEBRATE ANIMALS IN RESEARCH University of logo-Dartmouth Animal Care and Use Committee Rev. 11/29/05 This form must be filed whenever there are significant changes in your animal protocol AMENDMENT: Protocol Number:  Protocol Approval Date:  Date Renewal Submitted:  Date Renewal Approved:  NIH Grant No. Other Funding Source: Project Title: Principal Investigator: Project Period: Department: Telephone:   1. How many animals have been approved for the entire study?2. How many animals have been used thus far in the study? Ist yr  2nd yr 3. Are you proposing changes in any of the following: Number of animalsYesNoTechniquesYesNoSpecies of animalsYesNoAny other aspectsYesNoPersonnelYes 4. Have you encountered problems with the animals, their care, or procedures during the course of this experiment? (answer Yes or No)YesNo If Yes, explain:  Use Additional Pages if Necessary ________________________________ ______________________________ Signature of Principal Investigator Date ________________________________________ ______________________________________ Signature of Committee Chairman Date  ,a! " $ % / 0 A G _ c ɿദyndnYnN@nhC=h5CJOJQJhC=5CJOJQJhC=CJOJQJ\hC=CJOJQJhC=5CJOJQJh5CJOJQJhC=hC=5CJOJQJhC=CJOJQJhCJOJQJhC=h6CJOJQJhC=6CJOJQJhCJOJQJhrzCJOJQJhC=56CJOJQJh56CJOJQJh5CJOJQJhhC=,a" % 0 F G c ?kd$$If4pCH 6 af4d$ &#$/IfgdC=d@& $da$gdC=$da$ $d@&a$d@& c d j?kd$$If4hCH 6 af4d$ &#$/IfgdC=?kdv$$If4hCH 6 af4   b7kd$$Ifz4%%4 zasf4 d$If d&dP d@&gdC=d@&?kdF$$If4CH 6 af4 ! 4 C D Y [ sJkd`$$Ifz40% 4 zasf4 d$If7kd$$Ifz4%%4 zasf4 7 B G I M Y ] ^ . / f g ~     5 @ a c wߗߌxxhCJOJQJhCJOJQJh6CJOJQJh6CJOJQJh5>*CJOJQJh>*CJOJQJ\h5CJH*OJQJh5CJOJQJ\h5OJQJhCJOJQJh?5CJOJQJh5CJOJQJ%[ \ ] ?]kd*$$Ifz4,F ''`(    4 zasf4 d$If$d&dPa$Hkd$$Ifz40% 4 zasf4 ]kd$$Ifz4tF ''`(    4 zasf4 d$If ^      % ) * sjjjjjjjj d$If d$dN^`$da$ $ l da$]kd"$$Ifz4zF ''`(    4 zasf4 * - . d$If. / B  d$Ifkd$$Ifl4 d& dzJf!#R&~vvv((((4 laf4B F G J K ] a b e f d$If f g q  d$Ifkda$$Ifl4 d& dzJf!#R&~vvv((((4 laf4q v w x y z { | } ~ d$If ~   d$Ifkd$$Ifl4 d& dzJf!#R&~vvv((((4 laf4 d$If kdW$$Ifl4 d& dzJf!#R&~vvv((((4 laf4      6 7 8 9 bkd$$Ifx4rH@@@4 xaxf4 d$If$d$dNa$ 9 : ; < = > ? @ b c rbbbbbYQ$da$ $d@&a$$d&dPa$kd$$Ifx4rH@@@4 xaxf4 d$If c wd$da$5 0P/ =!"#$h% Dpt$$If!vh#vH:V 4p 6 5H/  / 4f4f$$If!vh#vH:V 4h 6 5H/  4f4f$$If!vh#vH:V 4h 6 5H/  4f4f$$If!vh#vH:V 4 6 5H/ 4f4W$$Ifs!vh#v%:V z45%44 zasf4W$$Ifs!vh#v%:V z45%44 zasf4e$$Ifs!vh#v #v:V z45 544 zasf4a$$Ifs!vh#v #v:V z45 544 zasf4$$Ifs!vh#v'#v`#v(:V z4,5'5`5(/ 44 zasf4s$$Ifs!vh#v'#v`#v(:V z4t5'5`5(44 zasf4$$Ifs!vh#v'#v`#v(:V z4z5'5`5(/ 44 zasf4$$If!v h#v#v~#vv#v#v#v#v#v#v v:V l455~5v555555 v4af4*$$If!v h#v#v~#vv#v#v#v#v#v#v v:V l455~5v555555 v/ / / / / / / / 4af4$$If!v h#v#v~#vv#v#v#v#v#v#v v:V l455~5v555555 v/ 4af4$$If!v h#v#v~#vv#v#v#v#v#v#v v:V l455~5v555555 v4af4s$$Ifx!vh#v#v#v@:V x4555@44 xaxf4$$Ifx!vh#v#v#v@:V x4555@/ / 44 xaxf4s2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@OJQJ_HmH nH sH tH @`@ NormalOJQJ_HmH sH tH FF  Heading 1$d@& CJOJQJLL  Heading 2$d@&56CJOJQJ>>  Heading 4 h^h>*CJ::  Heading 5 ^5::  Heading 6 ^>*::  Heading 7 ^6::  Heading 8 ^6: :  Heading 9 ^6DA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 4 4 Footer  !44 Header  !66  Footnote Text@>@"@ Title$a$5CJOJQJkH@Y2@  Document Map-D OJQJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] 8  c [ * . B f q ~ 9 c  8@0(  B S  ?\+\+\+ss}9*urn:schemas-microsoft-com:office:smarttagsplace=*urn:schemas-microsoft-com:office:smarttags PlaceType=*urn:schemas-microsoft-com:office:smarttags PlaceName "/0]aHqS"^`"o(^`.L^`L.^`.e e ^e `.5 L5 ^5 `L.^`.^`.L^`L.aHq         MC=USrzw?@@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialY CG TimesTimes New RomanK$ LinePrinterArial5. .[`)TahomaA$BCambria Math"CVZBGZBGI&  V24 3QVHP?0!xx (RENEWAL APPLICATION FOR APPROVAL OF THEmpStefanie Rezendes Oh+'0 ( H T ` lx,RENEWAL APPLICATION FOR APPROVAL OF THEmpNormalStefanie Rezendes2Microsoft Office Word@@&Uh@\*]@\*]՜.+,0$ hp  Forsyth Dental Center  )RENEWAL APPLICATION FOR APPROVAL OF THE Title  !"#$&'()*+,-./012345689:;<=>@ABCDEFIRoot Entry F!?]KData 1Table%#WordDocument78SummaryInformation(7DocumentSummaryInformation8?CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q