Qualifications Form

Qualifications Form for NMFS Permits
OMB No. 0648-0084; Expires: XX/XX/XXXX

Instructions: Please fill out this form and upload to your profile on the Authorizations and
Permits for Protected Species (APPS) webpage. Please only add 1 form per individual. See
examples of completed forms by permit type on our website.

Persons authorized as the Principal Investigator (PI) or Co-Investigators (CI) must demonstrate
qualifications commensurate with their duties. If sufficient experience is not provided,
personnel will not be authorized to conduct the proposed activities.
1.

Contact information

All documentation submitted will be publicly available. DO NOT include personal
information (e.g., social security number, date of birth, home phone).
Name (first, middle initial, last): _________________________________
Title: ______________________________________________________

Affiliation: __________________________________________________

Business e-mail address: ______________________________________

2.

Business phone number: ______________________________________

Table 1. Relevant Education
Degree

3.

Major/Field of Study

Institution and Location

Year Received

Relevant Experience

A. Table 2. Relevant Professional History
Job Title

Role

Affiliation

Location
(City, State,
Country)

Dates
(MM/YYMM/YY)

B. Summary of Experience
Please choose Option 1 (Table) OR Option 2 (Biosketch).

Option 1- TABLE. In the table below:
1. List all procedures (e.g., boat driver, photo-ID, biopsy sampling, suction-cup
tagging, dart tagging, capture and handling, UAS pilot, etc. [See Appendix 1 for a list of
commonly used procedures]) that you are requesting to perform under any NMFS
permit. Do not include procedures for which you have no experience. Note, this form
may be updated at any time. Only combine procedures in the same row for which you
have the same experience metrics.

2. Experience Metrics for each procedure:
a) To the best of your ability, estimate the number of animals, how long you have been
performing the procedure(s) (e.g., hours/months/years), and the species and age
class.
b) Most recent year performed.
c) Select the level of experience:
Level 1: I have assisted with, participated in, or received education/training in
performing this procedure, but have not successfully performed the
procedure.
Level 2: I have performed this procedure while under supervision or training of
an expert (e.g., PI, CI, or veterinarian).
Level 3: I have performed this procedure without supervision by a PI/CI.
Level 4: I am considered an expert in performing this procedure, and I have
supervised or trained others in performing this procedure.

Table 3. Summary of Experience.
Procedures

Experience Metrics: Estimated Number of Animals,
Hours/Months/Years, Species, and Age Class

Most Recent
Year
Performed

Level of
Experience

Option 2- BIOSKETCH
Provide a biosketch describing your experience with all the procedures (e.g., boat driver,
photo-ID, biopsy sampling, tagging, capture and handling, UAS pilot, etc. [See Appendix 1 for
complete list]) that you are requesting to perform under any NMFS permit. To the best of your
ability, please include experience metrics to estimate the number of animals, how long you
have been performing the procedure (e.g., hours/months/years), species, and age-class. Avoid
vague phrases such as “assisted with,” or “participated in,” which qualify as a Level 1
experience and will not adequately demonstrate your experience performing the procedure if
you have Level 2 experience or above.
2

4.

5.

6.

Relevant training, certificates, or licenses

Include additional information to support your qualifications including specialized
training (e.g., intrusive tagging, biopsy sampling, UAS) and certificates or licenses
(e.g., diver certification, Federal Aviation Administration certification) received
relevant to the procedures in Table 3 or your Biosketch. For training, include
description of training, year(s) received, and institution or expert who trained you.
For certificates or licenses, include year received and expiration date.

Relevant peer-reviewed publication history (2 pages maximum)

List your relevant publication history to support your qualifications. This list does
not need to be exhaustive, but should demonstrate that you have published or are
reasonably likely to publish in peer-reviewed journals, or make results of permitted
research available. You may provide a link to a webpage or Google scholar list for
your complete publication history.

Relevant reports and presentations (1 page maximum)

List other reports or presentations to support your qualifications as described
above.

3

Appendix 1. Procedures available in APPS, by taxa.
Cetaceans
Acoustic, active
playback/broadcast
Acoustic, passive recording
Acoustic, sonar for prey mapping

Auditory brainstem response test

Pinnipeds
Sea Turtles
Acoustic, active playback/broadcast Auditory brainstem response test
Acoustic, passive recording
Acoustic, sonar for prey mapping

Captive, (maintain or research)
Collect, remains for predation
study
Collect, sloughed skin

Administer drug, (IM, IV, IP,
subcutaneous, topical)
Anesthesia, (injectable sedative or
gas [cone, mask, intubation])
Auditory brainstem response test
Bioelectrical impedance
(subcutaneous or surface)
Calipers (skin fold)

Insert ingestible telemeter pill

Cognitive studies

Capture

Count/survey
Imaging, thermal

Collect, (molt, scat, spew, urine)

Instrument, bolt/pin

Instrument, external (e.g., VHF,
SLTDR)
Instrument, internal (e.g., PIT)
Mark, (bleach, clip fur, dye/paint,
flipper tag, freeze brand, hot brand,
neoprene patch)
Measure and weigh

Instrument, deep-implant
Instrument, suction-cup
Lavage
Mark, (freeze brand/ roto tag)
Measure and weigh

Bycatch reduction experiments
Captive, lab experiments
Count/survey
Epibiota removal

Imaging (e.g., MRI, CT, CAT, X-Ray)

Captive, maintain
Capture

Instrument, belt/harness
Instrument, dart/barb

Acoustic deterrent device trial
Bioelectrical impedance analysis

Insert stomach telemeter pill
Instrument, drill carapace
attachment
Instrument, epoxy attachment
(e.g., satellite tag, VHF tag)

Instrument, harness attachment

Count/survey

Instrument, suction-cup
attachment
Instrument, pygal attachment
Laparoscopy
Lavage

Mark, (PIT tag, carapace, flipper
tag, oxytetracycline injection, or
visual)
Measure and weigh
Orientation research

Metabolic chamber/hood
Observation, (mark resight,
monitoring, or behavioral)
4

Fishes
Anesthetize (MS-222 or
Electronarcosis)
Borescope
Captive, (breed, maintain, or
public display)
Captive, field studies
Captive, lab experiments

Collect eggs or sperm (wild)
Instrument, external (e.g., VHF,
satellite)
Instrument, internal (e.g., VHF,
sonic)
Laparoscopy
Lavage, gastric

Mark, (Carlin dangler, Floy T-bar,
bovine/DNA, coded wire, dart,
disk anchor, elastomer, or OTC)
Mark, (M-tag, PIT tag, double barb
tag, or roto tag)
Measure and weigh
Necropsy

Photograph/Video
Remote vehicle, aerial fixed wing
or (VTOL)
Remote vehicle, vessel or
amphibious

Salvage (carcass, tissue, or parts)
Sample, blood

Cetaceans
Measure colonic temperature
Metabolic chamber/hood

Observation, behavior or
monitoring
Photograph/Video and PhotoIdentification
Photogrammetry

Remote vehicle, vessel or
amphibious
Remote vehicle, aerial (VTOL or
fixed wing)
Restrain

Sample, swab (anal, blowhole,
oral, or vaginal)
Sample, blood
Sample, biopsy (skin, blubber, or
muscle)
Sample, exhaled air
Sample, biological (milk, urine,
fecal, or sperm)
Sample, tooth extraction

Tracking
Transport
Ultrasound
Underwater photo/videography
X-ray

Pinnipeds
Photograph/Video and PhotoIdentification
Photogrammetry

Sea Turtles
Photograph/Video

Recapture (gear removal)

Remote video monitoring

Remote vehicle, aerial (VTOL or
fixed wing)
Remote vehicle, amphibious or
vessel
Salvage (carcass, tissue, or parts)

Remote vehicle, aerial (VTOL or
fixed wing)
Remote vehicle, amphibious or
vessel
Restrain, (board, cage, hand, or net)

Sample, blood

Salvage (carcass, tissue, parts)

Sample, swab (cloacal, nasal, or
oral)
Sample, biological (fecal, fat, scute,
tissue, or tumor)
Sample, biopsy (bone, muscle,
organ)
Tracking
Transport

Sample, blood

Sample, biopsy (blubber, skin, or
muscle)
Sample, (nail, hair, or vibrissae)
Sample, swab (anal, nasal, ocular,
oral, fecal, or mucus membranes)
Sample, (milk, fecal [enema or
loop], urine, or stomach)
Sample, tooth extraction

Tumor removal
Ultrasound

Serial blood samples (Evans blue,
hormones)
Transport
Ultrasound
Underwater photo/videography
X-ray

5

Fishes
Sample, (barbel clip, fin clip, fin
ray, scute, scute spine)
Sample, biopsy (gill, gonads, liver,
or muscle)
Transport
Treatment, prophylactic or
therapeutic
Ultrasound

Paperwork Reduction Act Statement
The information requested in this form is required and is used to determine whether individuals
conducting activities proposed under a requested permit possess qualifications commensurate with their
duties and responsibilities (50 CFR 216.35).
Public reporting burden for this collection of information is estimated to average 1 hour per
response, including the time for reviewing the form, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information.

This information and any other associated documents are subject to the Freedom of Information Act.

Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person
be subject to a penalty for failure to comply with, a collection of information subject to the requirements
of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB
Control Number.

6

Qualifications Form for Public Display
OMB No. 0648-0084; Expires: XX/XX/XXXX

Instructions: Please fill out this form and submit with your permit application. Please only add 1
form per individual. See an example completed form on our website.
Persons authorized as the Principal Investigator (PI; individual overseeing the take or import),
Co-Investigators (CI; team leads for either take or import), and Veterinarians must demonstrate
qualifications commensurate with their duties. If sufficient experience is not provided,
personnel will not be authorized to conduct the proposed activities.

1.

Contact information

All documentation submitted will be publicly available. DO NOT include personal
information (e.g., social security number, date of birth, home phone).
Name (first, middle initial, last): _________________________________
Title: ______________________________________________________

Affiliation: __________________________________________________

Business e-mail address: ______________________________________

2.

Business phone number: ______________________________________

Table 1. Relevant Education
Degree

3.

Major/Field of Study

Institution and Location

Year Received

Relevant Experience

A. Table 2. Relevant Professional History
Job Title

Role

Affiliation

1

Location
(City, State,
Country)

Dates
(MM/YYMM/YY)

B. Summary of Experience. Please choose Option 1 (Table) OR Option 2 (Biosketch).

Option 1- TABLE. In the table below:
1. List all procedures (e.g., transport, restrain, capture [See Appendix 1 for a list of
commonly used procedures]) that you are requesting to perform under any NMFS
permit. Do not include procedures for which you have no experience. Note, this
form may be updated at any time. Only combine procedures in the same row for
which you have the same experience metrics.
2.

Experience Metrics for each procedure:
a) To the best of your ability, estimate the number of animals, how long you have
been performing the procedure(s) (e.g., hours/months/years), and the species
and age class.
b) Most recent year performed.
c) Select the level of experience:
Level 1: I have assisted with, participated in, or received education/training in
performing this procedure, but have not successfully performed the
procedure.
Level 2: I have performed this procedure while under supervision or training
of an expert (e.g., PI, CI, or veterinarian).
Level 3: I have performed this procedure without supervision by a PI/CI.
Level 4: I am considered an expert in performing this procedure, and I have
supervised or trained others in performing this procedure.

Table 3. Summary of Experience.
Procedures

Experience Metrics: Estimated Number of Animals,
Hours/Months/Years, Species, and Age Class

Most Recent
Year
Performed

Level of
Experience

Option 2- BIOSKETCH
Provide a biosketch describing your experience with all the procedures (e.g., transport,
restrain, capture [See Appendix 1 for complete list]) that you are requesting to perform under
any NMFS permit. To the best of your ability, please include experience metrics to estimate
the number of animals, how long you have been performing the procedure (e.g.,
hours/months/years, total number of transports), species, and age-class. Avoid vague
phrases such as “assisted with,” or “participated in,” which qualify as a Level 1 experience and
will not adequately demonstrate your experience performing the procedure if you have Level
2 experience or above.
2

4.

5.

Relevant training, certificates, or licenses

Include additional information to support your qualifications including
specialized training (e.g., intrusive tagging, biopsy sampling, UAS) and
certificates or licenses (e.g., diver certification, Federal Aviation
Administration certification) received relevant to the procedures in Table 3
or your Biosketch. For training, include description of training, year(s)
received, and institution or expert who trained you. For certificates or
licenses, include year received and expiration date.

Relevant reports, publications, or presentations (Optional; 2 page maximum)
List reports, publications, or presentations to support your qualifications as
described above.

3

Appendix 1. Take table procedures, by taxa.
Cetaceans
Capture
Captive (maintain or research)

Collect, sloughed skin
Count/survey
Imaging, thermal
Lavage
Measure and weigh
Measure colonic temperature
Observation, behavior or monitoring
Other

Photograph/Video and Photo-Identification
Photogrammetry
Remote vehicle, vessel or amphibious
Remote vehicle, aerial (VTOL or fixed wing)
Restrain
Sample, swab (anal, blowhole, oral, or vaginal)
Sample, blood

Sample, biopsy (skin, blubber, or muscle)
Sample, exhaled air
Sample, biological (milk, urine, fecal, or sperm)
Transport
Ultrasound
Underwater photo/videography

Pinnipeds
Administer drug (IM, IV, IP, subcutaneous, topical)
Anesthesia (injectable sedative or gas [cone, mask,
intubation])
Captive, maintain
Capture
Collect (molt, scat, spew, urine)
Measure and weigh
Observation, (mark resight, monitoring, or behavioral)
Other
Photograph/Video and Photo-Identification
Photogrammetry
Remote vehicle, aerial (VTOL or fixed wing)
Remote vehicle, amphibious or vessel
Restrain (board, cage, hand, or net)
Sample, blood
Sample, biopsy (blubber, skin, or muscle)
Sample (nail, hair, or vibrissae)
Sample, swab (anal, nasal, ocular, oral, fecal, or mucus
membranes)
Sample (milk, fecal [enema or loop], urine, or stomach)
Transport
Ultrasound
Underwater photo/videography

Paperwork Reduction Act Statement
The information requested in this form is required and is used to determine whether
individuals conducting activities proposed under a requested permit possess qualifications
commensurate with their duties and responsibilities (50 CFR 216.35).
Public reporting burden for this collection of information is estimated to average 1
hours per response, including the time for reviewing the form, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information.
This information and any other associated documents are subject to the Freedom of
Information Act.

Notwithstanding any other provision of the law, no person is required to respond to, nor
shall any person be subject to a penalty for failure to comply with, a collection of
information subject to the requirements of the Paperwork Reduction Act, unless that
collection of information displays a currently valid OMB Control Number.

4