ࡱ> 241 bjbj## 4AA ${0(XXXX333$s% r 33333 XX5www3XXw3wwmJX vKI:K0{B _ J J33w33333  w333{3333 333333333 : SHEPHERD UNIVERSITY Institutional Review Board Application for Review of Research Using Human Subjects Please provide the following information electronically, taking care to provide the information in a way that will be intelligible to non-specialists in your specific subject area. In addition, you must also fill in and submit an IRB Application Coversheet, which is available at  HYPERLINK "http://www.shepherd.edu/irb/irb-forms" http://www.shepherd.edu/irb/irb-forms . Before completing the Coversheet and the items below, you should review Shepherds IRB Policy Manual, also available at  HYPERLINK "http://www.shepherd.edu/irb/irb-forms" http://www.shepherd.edu/irb/irb-forms . i. Principal Investigator: ii. Faculty Sponsor (if PI is a student): iii. Project Title: 1. Purpose: Provide a brief description that describes the purpose of this research. 2. Subject selection: a. Who will be the subjects? How will you enlist their participation? If you plan to advertise for subjects, please include a copy of the advertisement. Will subjects be remunerated in any way, and if so, how? b. Will the subjects be selected for any specific characteristics? c. State why the selection will be made on the basis or bases given in 2(b). 3. Procedures: What precisely will be done to the subjects? Explain in detail your methods and procedures in terms of what will be done to subjects. Discuss design, instrumentation, and data collection. If you are using a questionnaire or handout, please include an electronic copy. 4. Risks and Benefits: Are there any foreseeable risks to the subjects? If so, what are these risks? What potential benefits will accrue to justify taking these risks? 5. Confidentiality: Adequate provisions must be made to protect the privacy of subjects and to maintain confidentiality of identifiable information. Explain how your procedures accomplish this objective. 6. Information and Consent Forms: State specifically what information will be provided to the subjects about the investigation. Is any of this information deceptive? State how the subjects informed consent will be obtained. If you wish the IRB to consider waiving the requirement for signed informed consent forms, please state that explicitly and explain why you believe that the requirement should be waived. Include the consent form that you propose to utilize. 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