Pacific University Research Participation Receipt
Student Name:
Date Submitted for Credit:
This sheet was developed to provide your instructor a record your participation in each research experience.
Please submit the receipt as one sheet (even if you only needed to participate in one study to complete your credit requirement)
FIRST STUDY
Study Title:
Principal Investigator/ course:
Date of Participation:
Time spent:
Examiner’s name:
Examiner’s signature:
SECOND STUDY
Study Title:
Principal Investigator/ course:
Date of Participation:
Time spent:
Examiner’s name:
Examiner’s signature:
THIRD STUDY
Study Title:
Principal Investigator/ course:
Date of Participation:
Time spent:
Examiner’s name:
Examiner’s signature:
FOURTH STUDY
Study Title:
Principal Investigator/ course:
Date of Participation:
Time spent:
Examiner’s name:
Examiner’s signature: