Animal Resources Center Animal Transfer Request

Date Transfer Submitted: __________________________

Date Transfer Required: ___________________________

Requestor Name & Phone: ________________________________________

Transfer from Billing/Grant #: ______________________

Transfer to Billing/Grant #: _________________________

Were any procedures performed on these animals prior to this transfer? _______

Current Information on Cage Card Information to be changed on Cage Card

Investigator: ____________________ Investigator: _________________________

Protocol #: _____________________ Protocol #: __________________________

Strain: ________________________

Vendor: ________________________

DOB: __________________________

Gender: ________________________

Date of Arrival: __________________

Total Number of Cages Transferred: ____________

Total Number of Animals Transferred: ___________

Please hang requests on appropriate animal room door or fax to 3692. For questions, contact Jean Kundert at 6809 or jkundert@montana.edu

For PROGRAM Transfers ONLY:

Were the mice currently under the PROGRAM grant? Yes____ No_____

If yes, which area of study are they being transferred out of (DSS Colitis, Salmonella, coxiella, rotavirus, etc.):

_______________________________ Are the mice being transferred out of the program? Yes___ No___

if “no,” then identify the program area of study the mice are going into: _______________________________

Dana’s Initials_______ (Required for PROGRAM Transfers only

For ARC use only:

ARC Admin. Initials: ________ Date: _________

ARC Husbandry Initials: _______ Date: _________

*ARC husbandry staff- Please return this form to Diane after you have made the appropriate changes to the cage cards.

Weaning Transfers

Protocol # ______ ______ ______ ______ ______ ______ ______ ______

# weaned ______ ______ ______ ______ ______ ______ ______ ______