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IRBFORMD (Southern College)

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FORM D
CERTIFICATION OF COMPLETION OF STUDENT CLASS PROJECTS
Instructor’s Assurance: By submitting this protocol, I attest that I am aware of the applicable principles,
policies, regulations, and laws governing the protection of human subjects in research and that I have
ensured that all student projects adhered to these principles. I also certify that I will maintain these
forms for no less than three years and I understand that the Chair of the IRB may periodically audit my
records.
All forms should be submitted by email to irb@southern.edu.
Class Name and Number:
_________________________________________________________________
________________________________________________ ____________________________
Instructor Signature: Date
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
For IRB Use Only:
Tracking Number ___________
Date Submitted ___________
Title of Class: _________________________________________________________________________
Instructor _____________________________________________________________________________
Semester ______________________________________________________________________________
Date Approved ______________
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Updated: 7/1/15
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Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Updated: 7/1/15
3
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
Student Name(s)
Title of Project
Date of
Completion
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IRBFORMD (Southern College)

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Completed 21 July 2020

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