STUDY INFORMATION Date IRB Number: (will be assigned by IRB office) Study Title: Principal Investigator or Social N/A Faculty Advisor: Security No. Department: Contact Person: (If applicable) Contact Person’s Role Pager: on Project: Contact Person’s Phone: Email: Fax: Is this a student project? Yes No PERSONNEL Please list all study personnel involved in the conduct of this study. All study personnel must complete required training in human subject research and provide to the IRB office certification verifying completion of the requirement. The IRB will not review a study without such forms on file for all research personnel. Only ECSU faculty, staff, students, or registered volunteers are considered and thus covered by the ECSU IRB review. All non-affiliated “ECSU-affiliated” study personnel must have their participation reviewed by the appropriate IRB. Name Social Security No. Department ECSU Role on Project affiliated N/A N/A N/A N/A
STUDY INFORMATION Date IRB Number: (will be assigned by IRB office) Study Title: Principal Investigator or Faculty Advisor: Social Security No. N/A Department: Contact Person: (If applicable) Contact Person’s Role on Project: Pager: Contact Person’s Phone: Fax: Email: Is this a student project? Yes No PERSONNEL Please list all study personnel involved in the conduct of this study. All study personnel must complete required training in human subject research and provide to the IRB office certification verifying completion of the requirement. The IRB will not review a study without such forms on file for all research personnel. Only ECSU faculty, staff, students, or registered volunteers are considered “ECSU-affiliated” and thus covered by the ECSU IRB review. All non-affiliated study personnel must have their participation reviewed by the appropriate IRB. Name Social Security No. Department ECSU affiliated Role on Project N/A N/A N/A N/A