Policy DPA-Exhibit #1 Research Applications

Policy Exhibit #1 - DPA (PDF)

Issue Date: August 15, 2018

Research Project Application Juab School District

This application must be accompanied by the research proposal, a copy of the instruments to be used, and a copy of any communication to be sent to parents of district students.

Name of person conducting research project:______________________________________
Phone number: _____________________ Date:__________________________________
Are you an employee of Juab School District? YES NO
College/University that you are conducting your research through:______________________

Proposal Title:_______________________________________________________________

Purpose of Study:____________________________________________________________

Summary of Methodology:_____________________________________________________ __________________________________________________________________________

Instruments to be used:________________________________________________________ ______________________________________________ ____________________________

School and Classroom/Department to be included:__________________________________

Number of Students to be included: ____________ Number of Teachers to be included:____

Proposed start date of project:________________ Proposed end date:__________________

College/University IRB Approval (please attach) YES NO

Other information you feel it is important for the committee to know concerning this request:
_________________________________________________________________________ __________________________________________________________________________

Proposal Approval Date:__________________ Proposal Denial Date:___________________ Comments:_________________________________________________________________

Committee Chair signature:___________________________________________________