Fillable Class Research Project Application Form (Southern Utah University)

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Class Research Project Application Form (Southern Utah University)

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CLASS RESEARCH PROJECT
APPLICATION FORM
Southern Utah University
CLASS RESEARCH PROJECT APPLICATION FORM
Information entered into this form may be lost if this file is not first
downloaded (i.e., saved to a local device) and then opened with Adobe
Reader or Adobe Acrobat prior to the entry of any information.
Name of Course Instructor E-mail
Phone Number Department
College/School Academic Year
Semester
Fall
Spring
Course Name
Course Number
and Section
In the area below describe each student research project that is part of the course listed
above. As ex officio members of the IRB, instructors have the authority to approve “student
research category B” projects described in policy 6.20. Please attach a copy of the course
syllabus, and indicate where aspects of human research ethics and participation are
discussed. This form must be submitted at least two weeks before the research is to begin.
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Descriptive Title of
Research Project Investigator(s)
Estimated # of
Participants
Since student research projects will not be individually reviewed by the IRB, the informed
consent information (written or verbal) must include the following statement:
This survey (project etc…) is being conducted in partial fulfillment of the course requirements for
(course title) taught by (instructor's same) at Southern Utah University. This course in
compliance with the course certification requirements of SUU’s Institutional Review Board (IRB).
Please confirm that you will have the student research projects which are under your
supervision include the required statement.
I agree to make sure all the projects' informed consent include this statement.
Course Instructor's Typed Signature Date
Please submit this proposal via email to irb@suu.edu along with any applicable
attachments or supplemental materials.
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Class Research Project Application Form (Southern Utah University)

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Completed 23 July 2020

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