Visiting Researcher Application Form

Your details

First Name * :

Last Name * :

Home Address

Street Address * :

Postal / Zip Code :

Daytime Telephone Number * :

Mobile Telephone Number * :

Email Address * :

Research details

Academic Institute * :

Course of Study (if student) * :

Supervisor's Name (if student) * :

Supervisor's Email Address :

Anticipated Start Date if Visiting Zoo/Reserve Site * : in dd/mm/yyyy format

Anticipated Duration of Visit * :

If Questionnaire or Sample Request Latest Return Date * : in dd/mm/yyyy format

Project Title * :

Common Name of Species or Group * :

Scientific Name * :

Order * :

Project Keywords * :

Brief Introduction (500 words max) *
Rationale for the project, why is it interesting or necessary

Methods (1000 words max) *
Please give detailed methods of exactly what data will be collected and how, what will be required of the zoo/Trust, how long it will take etc

Outcomes (300 words max) *
What are the intended outcomes of the research

Helping Halt Species Decline (50 words max)*
Please specify how the proposed research will contribute to the Wild Planet Trust mission of Helping Halt Species Decline