Application Form IKSP and Customary Laws Research and Documentation Name of Applicant: ________________________________________________________________________ Residential Address: ________________________________________________________________________ _____________________________________________________________________________ Office/Business Address: __________________________________________________________________ _____________________________________________________________________________ Contact Number: _______________________________________________________________________ Purpose of the Research: ___________________________________________________________________ ____________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ Funding Source: ________________________________________________________________________ Proposed Timeframe of Research: ___________________________________________________________ Proposed IC/IP community/ies where research will be conducted: ____________________________ ____________________________________________________________________________ ____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________ Name and Signature of Applicant _____________________________________ Date x--------------------------------------------------------------------------------------------------------------x To be accomplished by NCIP staff Date: ___________________________________________ Application Fee Official Receipt No. _______________________________________________________ Attachments Submitted: ____________________________________________________________________ _____________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Remarks:_________________________________________________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ __________________________________________________________________________________________ 18