Fillable Class Research Project Report Form (Southern Utah University)

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Class Research Project Report Form (Southern Utah University)

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CLASS RESEARCH PROJECT
REPORT FORM
Southern Utah University
Institutional Review Board
CLASS RESEARCH PROJECT REPORT 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
Describe any problems or concerns occurring in connection with the administration of any of the
projects:
I certify that all of the projects listed above were conducted in compliance with policy 6.20 on
student research category B projects. All elements of informed consent for minimal risk
research were provided to each participant, and each participant agreed to participate thereafter.
YES NO
Course Instructor's Signature (Typed Signature)
Date
Please submit this form via email to irb@suu.edu along with any applicable
attachments or supplemental materials.
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Class Research Project Report Form (Southern Utah University)

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Completed 22 July 2020

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