Resources General Requirements for Informed Consent IRB Paper Application Packet (PDF) IRB Sample Consent Form (PDF) Due to a technical issue with Internet Explorer, please use Chrome, Firefox, or Safari to submit your application. Institutional Review Board (IRB) Application The IRB application becomes the permanent record of the researcher(s) compliance with laws and regulations protecting the rights and welfare of human research participants. Sufficient detail of the proposed protocol must be included to permit the IRB to render a decision about whether the safeguards in the research protocol protect the rights and welfare of human participants and benefits justify any risks. Applications with insufficient detail will be returned, without review. Student researchers must obtain faculty advisor review, approval and signature prior to IRB submission. Consult with your research supervisor for more information on research protocols that may be considered exempt, qualify for expedited review, or require standard IRB review. Step 1 of 5 20% Before You BeginGather everything you will need to fill out this form before starting, you will not be able to save along the way. Download a copy of the Application Packet and read it in it's entirety before starting. Identifying InformationPrincipal Researcher* First Last Additional Researchers(separate with commas)Instructor*Course*Semester*Faculty Advisor*Project Title*Principal Researcher’s Position at Sierra Nevada College*ProfessorAdvanced Degree Candidate/StudentUndergraduatePrincipal Researcher Contact InformationAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Category that best describes your research*Master’s Thesis/ProjectUndergraduate ResearchFaculty or Staff Professional/Academic ResearchSNC Institutional ResearchSchedule of ResearchState when (approximate dates) and where the activities involving human participants will take place. The beginning date must follow IRB approval. If location(s) require permission, attach authorization letters.Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Purpose(s) of research*Include research questions and key variables. Submit abstract.Procedure*Briefly describe sample size, characteristics of sample participants, methods and procedures involving human participants. Management of Personal InformationWill your experiment involve questionnaires?*YesNoAre the questionnaires anonymous?*YesNoBriefly describe questionnaire content*Attach questionnaire*Accepted file types: doc, docx, pdf.Allowed formats: doc, docx, pdf, zipDescribe measures to manage custody of data and maintain confidentiality and/or anonymity*Personal SafetyWill your experiment require physical exertion from participants?*YesNoIf participants are required to complete physical activities, explain why and describe the activity:*Describe risks, measures to reduce risks, and measures to screen participants for high risk of injury:*Explain why benefits of study justify these risks:*Counseling ServicesDoes the study have a risk of eliciting emotional disturbances in the participants?*YesNoIf there is an emotional risk to participants, describe counseling services you will offer or require after the experiment:*Explain how the benefits of study justify these risks:* ConsentAre the participants aware of their involvement in the project?*YesNoIf participants are aware, are they also aware of the study’s purpose?*YesNoExplain the depth of explanation of the study to participants:*Do you explicitly ask participants for their consent to be in the project?*YesNoIf so, attach a consent form*Accepted file types: doc, docx, pdf, zip.Download Sample Consent FormPopulation ConcernsDoes your study involve participation from individuals selected from a vulnerable population?*YesNoIf so, take care to observe this in your consent form and arrange for the additional signatures of a parent/legal guardian and appropriate witness (principal, teacher, etc.).Which of the following vulnerable populations are included in your study* Children and/or adolescents (anyone under the age of 18) Persons with Intellectual or Developmental Disabilities Frail Older Adults Adults with Physical Disability or Mental Illness Adults with legal guardians Specific targeted racial subgroups or ethnic backgrounds Other special populations targeted in the study protocol To your knowledge, if collecting data from a sample of a special population (e.g., prisoner populations, people with legal guardians, those under the age of 18, etc.), are there any relevant laws or regulations? If so, explain how your research design addresses these laws or regulations.*If your study includes participants from vulnerable populations, describe how your protocol protects or accommodates their special vulnerabilities.*If your study’s sample targets specific racial or ethnic minorities, explain why this is necessary. Further, describe how language and cultural sensitivity issues are addressed in your protocol.*Briefly describe the training and experience that qualifys you to carry out the proposed research involving more than a minimal risk to participants or including vulnerable populations.* DebriefingIf sensitive issues are raised in your research protocol or if deception is used, describe the nature of any debriefing of participants. If not providing a debriefing session, state “No debriefing” and justify your decision.*Describe any protocol(s) for providing participants with additional, pertinent, information subsequent to their contribution.*DocumentationCopywritten Materials List*List the title(s) and attach copies of any copyrighted tests, questionnaires, or other material to be used in your study. Attach below evidence of permission to use the copyrighted material (i.e., purchase invoice, letter, or email from author or publisher). If security or copyright prohibits attachment, explain. If none of these documents are to be used, state “No copyrighted tests or questionnaires.”Other Attachments List*Other potential and necessary attachments (when incorporated as part of your study) include letters of approval from participating organizations on official letterhead, all other specially designed or public domain tests, interview protocols, questionnaires, etc.Supplemental FilesAccepted file types: zip, doc, docx.Formats allowed: zip, doc, docxAccepted file types: zip, doc, docx.Accepted file types: zip, doc, docx.Submission* I have read the General Requirements for Informed Consent. * I have read pages 1-8 of the Application Packet.