Data Access Request Form v1.0 Page 4 of 5
10) Peer Review Process Through Michener’s Data Access Review Committee (DARC)
If access to the data requested in this form is approved, you will be required to submit your manuscript
(article, presentation, etc.) for peer review by Michener’s DARC at least 5 business days before the
intended presentation or publication.
Please specify the date below that you expect to submit your presentation or manuscript for Michener
Date of Submission for Michener Peer Review: ____________________________________________
Date of Intended Presentation or Publication: _____________________________________________
11) Please indicate whether or not you will identify the Michener Institute in your research as the source of
the data requested, and briefly explain why you plan to identify or not identify Michener.
Section F: Applicant Agreement and Signature
12) Applicant Agreement
I agree to the following conditions with regards to access to the data requested in this form, if approved by
Michener’s Data Access Review Committee (DARC).
a) The data requested will be used only for the project or purpose outlined in this request form and
only published, presented or disseminated as outlined in this request form. I understand that if I
should wish to use the requested data in the future for some other project or purpose or to publish,
present or disseminate it in ways other than specified in this request form, I must submit a new
request form to Michener’s DARC to seek approval.
b) I understand that any proposed research involving human participants carried out at or in
collaboration with The Michener Institute must be reviewed and approved by Michener’s Research
Ethics Board (REB) before the research can begin. I understand that if the data requested in this form
pertains to Michener faculty, staff or students or other individuals associated with Michener, I must
submit an application to Michener’s REB to obtain approval to conduct my proposed research using
the data requested in this form. Approval to access to Michener’s data by the DARC does not
constitute permission by Michener’s REB to conduct the proposed research outlined in this form.
Applicant Signature Date
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