Child Development Center
Application for Research Projects with Children/Staff/Families
in the
Child Development Center
Bowling Green State University
To be completed by CDC Director
Date received
CDC 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 Center
122 Johnston Hall
Bowling Green, Ohio 43403
419-372-7834
www.bgsu.edu/colleges/edhd/cdc/
Application for Research Projects with the Children/Staff/Families in the CDC
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?
B. Individuals needed:
Number
Yes
Age
Other characteristics:
C. Number of sessions per individual:
Approximate length of each session:
III. Location of proposed activities
CDC Classroom
Other:
2
No
Uncertain
Sex
Application for Research Projects with the Children/Staff/Families in the CDC
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
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:
3
email:
Friday
Application for Research Projects with the Children/Staff/Families in the CDC
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 Center 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 Center 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:
Vicki Knauerhase, Administrator
Child Development Center
Johnston Hall B.G.S.U.
419-372-6909 at least 10 days prior to anticipated starting date.
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