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Individual Application

This form is to gather relevant information for the Snow Leopard Network member database. Please fill in the appropriate information. Required fields are marked with an asterisk ^*. Please complete all required fields or your application will not be processed. Thank you in advance and we look forward to hearing from you.

Step 1. Contact Information
Enter your contact information below.

Contact Information
Family Name:	^*
First Name:	^*
Title: (Dr. Mr., Ms., etc.)	^*
Affiliation:	^*

Work Address: ^*		Home Address:
Street address line 1:		Street address line 1:
Street address line 2:		Street address line 2:
City, etc:		City, etc:
State, Province, etc:		State, Province, etc:
Postal code:		Postal code:
Country:		Country:

Office phone:		Home phone:
Office fax:		Home fax:
		Mobile:

Office Email:		Home Email:
Website:

Step 2. Area of Expertise ^*
List up to 3 species/sub-species that you have expertise in and select the type of expertise. This could include snow leopard and their prey, other cats, other carnivores, etc.

Area of Expertise

Type of Expertise

Species:

Sub Species:

Research

Conservation

Education

Other

Country of Expertise (Select all that apply)
All of Snow Leopard Range	Mongolia
Afghanistan	Myanmar
Bhutan	Nepal
China	Pakistan
India	Russia
Kazakhstan	Tajikistan
Kyrgyzstan	Uzbekistan

Area of Professional Interest or Expertise (Select up to five)

	Biodiversity
	Genetics
	Ecology
	Wildlife population management
	Habitat assessment
	Habitat fragmentation
	Land stewardship
	Grazing
	Wildlife disease
	Wildlife nutrition
	Policy
	Education
	Conservation planning
	Community-based conservation
	Participatory rural assessment

	Conflict resolution
	Local knowledge (resource use, medicine, etc.)
	Impacts of development (mines, timber, roads, etc.)
	Poverty alleviation
	Hunting
	Trade in wildlife
	Enforcement
	International cooperation/agreements
	Captive breeding/management/zoos
	Biometrics/statistics
	Computer applications
	Technology (GIS, telemetry, etc.)

Step 3. Curriculum Vitae ^* and Notes
Please enter a brief CV, maximum 500 words. (This is a required component to your application.)

Curriculum Vitae

Notes (optional):

Add any additional information you would like to have considered in your application.

Step 4. Privacy Information^*
All information on this form will be available to other SLN members through our website. The general public will have access to your name, country, and affiliation. Please indicate, below, which other information you want the general public to access about you.


Privacy Information Accessible to General Public (yes/no)?

Office Email: Yes   No

Office Postal Address: Yes   No

Office Telephone: Yes   No

Office Fax: Yes   No

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Tel. (206) 632-2421 - email: info@snowleopardnetwork.org