Name of Principal Investigator: ______________________________________________________

Department:__________________________________________  Email Address___________________________________________

Campus Mailing Address and Phone Number_________________________________________________________________________

Federal regulations and college policy require that proposals which involve human participants in research must be reviewed by the IRB. Please respond to the following questions and return this form and 10 copies, when complete, to Gary Goodnough, Chair of the IRB, MSC 38.

1. Title and description of project. Include a time line for when you plan to collect data.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

2. Indicate how informed consent is to be obtained. Provide a copy of the informed consent documents you will use in your research. If your research involves a survey or interview questions, please provide these.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

3. How will confidentiality of participant data be assured as it is collected, and, if it is to be retained, over the length of time that it is to be retained.

4. List all foreseeable risks which may be encountered by the subjects and the justification for the project in terms of benefits to be realized which might outweigh the risks, and steps taken to reduce any potential risks.
 
 
 
 
 
 
 
 
 

For student projects only:

This research has been reviewed and approved by my instructor, who is:

___________________________________________________________________

Name Title
 
____________________________________________________________________

Signature