ࡱ> 796 Wbjbj 4rr2 $8> J$nnnnn]]]QSSSSSS$xdw]]]]]wnn   ]FnnQ ]Q   npzj =0    0]] ]]]]]ww ]]]]]]]]]]]]]]]] :  INSTITUTIONAL REVIEW BOARD Application for Approval of Research Involving Human Subjects (Cover Sheet) (Protocols meeting Full Board Review must be submitted two weeks prior to the date of the IRB meeting on which the review is to occur.) Please Check One: ___New Project ___ Renewal ___Modification (Attach Renewal/Modification Form) Date of Submission: __________ Protocol Title: _________________________________________________________ Principal Investigator: Typed name: _________________________________ Signature: ___________________________________ Department or School: _________________________ Email: ______________________________________ Telephone number: ____________________________ Co-Investigator: Typed Name: _____________________________________ Signature: ________________________________________ Email: ________________________________________ Co-Investigator: Typed Name: _____________________________________ Signature: ________________________________________ Email: __________________________________________ Co-Investigator: Typed Name: _____________________________________ Signature: ________________________________________ Email: ___________________________________________ Faculty Advisors Statement (student projects only): I, _______________________ am the advisor for __________________________. My signature below indicates that I have read the attached protocol and have checked the contents with the IRB Guidelines. I thereby recommend this protocol as: Exempt Review______ Expedited Review ____ Full Board Review ____ Signature:_____________________________ Email: ____________________________ Source of Support (if any): Level of Risk to Human Participants: _______Minimal _______ Greater than minimal Number of Participants: _______ *Normal participants are (a) over the age of 18 (b) able to make independent decisions with full mental capacity. Children are minors under the age of 18. Are vulnerable populations involved?* ___yes ___no Are children involved?*___yes ___no Has this proposal been or will it be submitted to other Human Subjects Review Boards, departmental committees, or community agencies for review and approval? ____Yes (attach approval letters) _____No     UPS IRB PROTOCOL # t J l $ ? 1235689;<>QRTVWξαhF h jhF(h jhFCJOJPJQJaJnHtHjhB9UhB9hFhFOJPJQJhFhF56OJPJQJhFhF6OJPJQJ hFhFCJOJPJQJaJ#hFhF5CJOJPJQJaJ5t l r & X   V $d5$7$8$9DH$a$gdFd5$7$8$9DH$gdF$d5$7$8$9DH$]a$gdF$d5$7$8$9DH$a$gdF  = r s # $ G3d$d%d&d'd5$7$8$9DH$NOPQgdF$d5$7$8$9DH$a$gdF'$ # p@ P d5$7$8$9DH$a$gdFMNno  gh0124578:;=> dgdFd5$7$8$9DH$gdF$d5$7$8$9DH$a$gdF>QRSTUVWkiigggnkd$$Ifl$h% t0644 lap yt j% H$d$5$7$8$9DH$Ifgd jl 21h:pF/ =!"#c$% $$If!vh#vh%:V l t065h%p yt jj 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ OJPJQJ_HmH nH sH tH J`J Normal dCJ_HaJmH sH tH DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List >@> F0HeaderdH$.. F0 Header Char> > F0FooterdH$.!. F0 Footer CharR@2R F0 Balloon Text dCJOJQJ^JaJNoAN F0Balloon Text CharCJOJQJ^JaJ`S F Table Grid7:V0 d PJnHtHPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] W  #####&W  >W L# @0(  B S  ?2 4 5 7 8 : ; = > U X 0:6<2 4 5 7 8 : ; = > U X 333R'B9: jFc2 4 @W @UnknownG*Ax Times New Roman5Symbol3. *Cx Arial3*Ax TimesY New YorkTimes New Roman7.@Calibri5. .[`)TahomaA$BCambria Math"hS*S*__qc20. . KHP  $PF2!xx kirsten wilburJimmy McMichaelOh+'0, px   $kirsten wilbur Normal.dotmJimmy McMichael2Microsoft Office Word@@(c@(c_՜.+,0 hp  .   Title  !"#$%'()*+,-/0123458Root Entry Fpz:Data 1TableWordDocument4SummaryInformation(&DocumentSummaryInformation8.CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q