Application to Use the Psychology Department’s Participant Pool
Instructions: Do not complete this form until you have already received approval from the Institutional Review Board. If you have
received IRB approval (and your professor’s approval if you are a student) to proceed with your study, please thoroughly complete
this form on your computer. After completing and proofreading the form, please email it as an attachment to the participant pool
coordinator.
1. Principal Investigator*:
_________________________________________________________
Name
_____________________
Email
_________________________
Phone Number
2. List all students associated with this project
_________________________________________________________
Name
_________________________________________________________
Name
_________________________________________________________
Name
_________________________________________________________
Name
_________________________________________________________
Name
_____________________
Email
_____________________
Email
_____________________
Email
_____________________
Email
_____________________
Email
_________________________
Phone Number
_________________________
Phone Number
_________________________
Phone Number
_________________________
Phone Number
_________________________
Phone Number
3. Faculty Supervisor (if the principal investigator is a student): _____________________________________________________
* The principal investigator is the person who will receive all correspondence from the participant pool coordinator. Student research
teams should select one team member to be the principal investigator.
Note:.If your request is approved, you may only run as many participants and award as much credit as the participant pool
coordinator specifies . Do not run extra participants without checking with both your advising professor and the participant pool
coordinator.
4. How many minutes will your study take? (Carefully pilot test your study to check required completion time.) ________
5. Will you be collecting data online (e.g., surveymonkey)?  YES
 NO
6. How many participants do you need? (See note above; students please consult with your professor.) _________
Note: The following questions refer to the letter from the IRB. Do not complete this form if you have not yet received IRB approval.
7. Has this study been reviewed and approved by the Institutional Review Board? ___________
8. What is the date of the approval letter you received from the IRB? _________________________________
9. What is the title of your study in the IRB’s records? (The IRB letter should include your study name in quotes.)
___________________________________________________________________________________________________
10. What is the name of the university official who signed the IRB letter?_______________________________________________
If your application is approved, I will email you the link to the online system and you (and any students associated with the project)
will need to:
a. Register as an EXPERIMENTER.
-You will not be able to log in to the system until I have approved you as an experimenter.
b. Once I have approved you as an experimenter, fill out all the details for your study.
-Then, I will approve your study and you are ready to start scheduling participants.
Note: It may take up to 1 week for the participant pool coordinator to approve all of your application materials. Please plan
accordingly and keep checking the online system.
After you have thoroughly completed and proofread this form, please email it (as a *.doc attachment) to the coordinator:
Dr. Dudley, 618-650-3453, mdudley@siue.edu