Child Development Center s1

Child Development Lab

Application for Research Projects with Children/Staff/Families in the Child Development Lab - Bowling Green State University

To be completed by CDL Director Date received CDL Project number Approved by date Approved by date Approved by date Approved by date teachers To be completed by person responsible for the project Type of project Investigator Population ( )Faculty Research ( )Faculty ( )2 ½ – 5 year olds ( ) Demonstration ( ) Staff ( ) Center Staff ( ) Class Project ( ) Graduate Student ( ) Parents/families Dept. & Course # ( ) Independent Study ( ) Other (specify)

I. Proposed Project: A. Brief description of the project including purpose or research hypotheses, theoretical or educational significance, the specific activities participants will be involved in and the benefits to the participants.

Child Development lab Bowling Green, Ohio 43403 122 Johnston Hall 419-372-7834 www.bgsu.edu/colleges/edhd/cdc/ Application for Research Projects with the Children/Staff/Families in the CDL

B. Type of response required of participants:

C. Confidentiality of Data:

(Briefly describe the precautions which will be taken to safeguard identifiable records of individuals. Be specific about the long range and immediate use of data by you and others.)

II. Participants A. Will the participants in the proposed activities be placed “at risk” as defined in the Use of Human Subjects in Research at BGSU? Yes No Uncertain

B. Individuals needed: Number Age Sex Other characteristics:

C. Number of sessions per individual: Approximate length of each session:

III. Location of proposed activities CDL Classroom

2 Application for Research Projects with the Children/Staff/Families in the CDL

Other:

IV. Schedule A. Date project will begin:

B. Anticipated completion date:

C. Indicate weekly schedule for the hours when someone will be working directly with the children, collecting data, etc.

Monday Tuesday Wednesday Thursday Friday Dates:

8:30 –11:00

1:00 – 4:00

V. A. Person(s) responsible for activity: Name of Responsible Project Supervisor:

Address:

Phone: email:

Persons who will work with the participants:

Name: Name:

Address: Address:

Phone: email: Phone: email:

VI. Certifications 1. I am familiar with The Use of Human Subjects in Research at BGSU (available from the Research Services Office, 372-2481), the Ethical Standards of the American Psychological Association, and the Child Development Lab procedures. I subscribe to the standards described therein and will adhere to these policies and procedures in this project. 2. If this is a Research Project, indicate date approval was granted by the BGSU Human Subjects Review Board. Date: 3. Should changes in procedures in involving human subjects become necessary, I will submit them for review prior to initiating the change. 4. If any problems involving human subjects emerge, I will immediately notify the Director of the Child Development Lab and the Human Subjects Review Board. Signatures: Responsible Project Supervisor: Department: Investigator: (if different) Department: This must be signed by both the person responsible for the project and everyone who will interact with the participants. Add lines if needed VII. Submit to: Jeanine Jechura, Administrator Child Development Lab Jordan Family Development Center 812 N. College Bowling Green, OH 43402 419-353-7407 ext. 227 at least 10 days prior to anticipated starting date.