*Please note, this form should be filled out only by students whose projects WILL require IRB review. Name Department Email Address Faculty Sponsor Project Title Have you begun entering your project in Kuali? Yes No If yes, what is your protocol ID number? Provide an approximate date for beginning data collection. Year Year202220232024202520262027 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Provide an approximate date for completion of data collection. Year Year202220232024202520262027 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Provide up to three dates and times you would be available to meet with an HRPO staff member. You will be contacted via email to confirm the meeting date. Provide information for Date 1: Year Year20212022202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Date 2: Year Year20212022202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Date 3: Year Year20212022202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Time for Date 1: Hour Hour123456789101112 : Minute Minute00153045 am pm Time for Date 2: Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Time for Date 3: Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Please provide a brief description of your research study. Be sure to include a brief statement of the purpose of the study as well as a brief description of the type(s) of research method(s) you plan to use (observation, survey, focus group, interviews). Leave this field blank
