Language & Linguistic Science ethics committee research approval request form If you are collecting any data from human subjects, you must fill out this form. You may not begin data collection until you receive notification that your research has been approved. It is your responsibility to familiarise yourself with the University's Code of practice and principles for good ethical governance. There is a set of Guidance Notes accompanying this form; it is recommended that you read through the notes first to help you plan your responses to the questions, and to reflect on any ethical questions raised by your planned research. The particulars of your answers to some of the questions may differ depending on the research design of your individual project, but the Guidance Notes offer advice and in some cases sample wording for answers. If you have any additional queries, do not hesitate to contact your supervisor or the Chair of the Ethics Committee at <linguisticsethics@york.ac.uk> NB: If you are collecting data from NHS patients or staff, or Social Service users or staff, you will need to apply for approval through the Integrated Research Application System (IRAS) at https://www.myresearchproject.org.uk/Signin.aspx Staff: please fill in the IRAS form first and send your completed form to L&LS Students: applications for approval through IRAS should normally be pre-reviewed by the L&LS ethics committee Completed forms should be submitted to the L&LS Ethics Committee as follows: 1. One electronic copy of the compliance declaration and one electronic copy of the Ethics form including the Information sheet and consent form entitled “SURNAME ethics submission MONTH YEAR” via email to <linguistics-ethics@york.ac.uk> Any other questionnaire submitted should be pasted at the end of the ethics form to create a single submitted document. 2. One signed Compliance form, to be submitted to the department office, once approval has been granted. Initial decisions will normally be made and communicated within two weeks of the receipt of your complete application. last edited: 06/01/2016 Page 1 of 9 SUBMISSION FORM 1a. Please provide the following details about the principal investigator at YORK Name of Applicant: Email address: Telephone: Staff/Student Status: Dept/Centre or Unit: Head of Department: Chair of Dept. Research Committee: Language & Linguistic Science Peter Sells, peter.sells@york.ac.uk Dunstan Brown, dunstan.brown@york.ac.uk 1b. Any other applicants (for collaborative research projects) Name of Applicant: Email address: Telephone: Staff/Student Status: Dept/Centre or Unit: Head of Department: Head of Research: (if applicable) 2. (STUDENTS ONLY) Please provide the following supervisory details for your project: PLEASE NOTE: By submitting this form, you confirm that your supervisor has approved the summary of your research proposal and the participant information sheet. 1st Supervisor, email address 2nd Supervisor, email address last edited: 06/01/2016 Page 2 of 9 3. Please provide the following details about your project: Title of Project: Date of Submission to L&LS Ethics Committee: Project Start Date: Duration: Funded Yes/No: If funded, give source: External Ethics Board Jurisdictions: last edited: 06/01/2016 Page 3 of 9 4. Summary of research proposal 4.1 Aims and objectives of the research Please outline the questions or hypotheses that will be examined in the research. (PLEASE DO THIS IN A WAY THAT WILL BE COMPREHENSIBLE TO NON-LINGUISTS.) [500 words max.] 4.2 Methods of data collection Outline how the data will be collected from or about human subjects. 4.3 Recruitment of participants How many participants will take part in the research? How will they be identified and invited to take part in the study? How will informed consent be obtained? 4.4 Participant information sheets and consent forms Please attach (to the end of this form): (1) the project information sheet to be given to all participants and (2) the informed consent form (n.b. failure to submit these documents will result in your application being returned without decision). i. Please confirm you have included the participant information sheet and the consent forms to be given to all participants with your submission to L&LS. If these have not been attached, please explain why this is the case. last edited: 06/01/2016 Page 4 of 9 ii. Are the results to be given as feedback or disseminated to your participants (if yes please specify when, in what form, and by what means) 4.5 Anonymity In most instances the Committee expects that anonymity will be offered to research subjects. Please set out how you intend to ensure anonymity. If anonymity is not being offered please explain why this is the case. 4.6 Data Collection All personal and sensitive data must be collected and stored in accordance with the Data Protection Act 1998. Please set out all the types of data you will be collecting (e.g. interviews, questionnaires, recordings) i. Please detail type(s) of data. ii. Where is the data to be collected and where will it be stored electronically? Please describe what protection there will be in relation to electronic storage. iii. Where is the data to be stored in paper form? Please describe how this will be protected. last edited: 06/01/2016 Page 5 of 9 iv. At what point do you propose to destroy the data? v. If you are sharing data with others outside your department, what steps are you taking to ensure that it is protected? vi. If the data is to be exported outside the European Union, what steps are you taking to ensure that it is protected? (Note: you must identify how you will comply with Data Protection Act 1998 requirements.) 4.7 Perceived risks or ethical problems Please outline any anticipated risks or ethical problems that may adversely affect any of the participants, the researchers and or the university, and the steps that will be taken to address them. (Note: all research involving human participants can have adverse effects.) i. Risks to participants (e.g. emotional distress, financial disclosure, physical harm, transfer of personal data, sensitive organisational information…) ii. Risks to researchers (e.g. personal safety, physical harm, emotional distress, risk of accusation of harm/impropriety, conflict of interest…) last edited: 06/01/2016 Page 6 of 9 iii. University/institutional risks (e.g. adverse publicity, financial loss, data protection…) iv. Financial conflicts of interest (e.g. perceived or actual with respect to direct payments, research funding, indirect sponsorship, board or organisational memberships, past associations, future potential benefits, other…) v. Please draw the committee’s attention to any other specific ethical issues this study raises. last edited: 06/01/2016 Page 7 of 9 5. Ethics checklist Please confirm that all of the steps indicated below have been taken, or will be taken, with regards to the above named project submitted for ethical approval. If there are any items that you cannot confirm, or are not relevant to your project, please use the space provided below to explain. Please tick if true, otherwise leave blank: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Informed consent will be sought from all research participants where appropriate All data will be treated anonymously and stored in a secure place All Relevant issues relating to Data Protection legislation have been considered (see http://www.york.ac.uk/recordsmanagement/dpa/) All quotes and other material obtained from participants will be anonymised in all reports/publications arising from the study where appropriate All reasonable steps have been taken to minimise risk of physical/ psychological harm to project participants. All reasonable steps have been taken to minimise risk of physical/mental harm to researchers Participants have been made aware of and consent to all potential futures uses of the research and data With respect to indemnity Sue Final (University IP Manager e-mail: sue.final@york.ac.uk) has been made aware of the research, where appropriate There are no known conflicts of interest with respect to finance/funding If applicable, please explain in the space below why any of the above items have not yet been confirmed: last edited: 06/01/2016 Page 8 of 9 6. Other comments Are there any issues that you wish to draw to the Committee’s attention (it is your responsibility to draw the committee's attention to any ethical issues that may be of perceived or actual interest)? 7. Submission Checklist for Applicants Finally, please sign the form and ensure that all of the indicated documents below are sent electronically to via email to <linguistics-ethics@york.ac.uk >. ☐ L&LS Application form ☐ Consent form for participants ☐ Information Sheet for participants 8. Signed undertaking In submitting this application I hereby confirm that there are no actual or perceived conflicts of interest with respect to this application (and associated research) other than those already declared. Furthermore, I hereby undertake to ensure that the above named research project will meet the commitments in the checklist above. In conducting the project, the research team will be guided by the Social Research Association’s/AHRC’s/ESRC’s ethical guidelines for research. ……………………………………………...………….. (Name of Lead Researcher/Principal Investigator) ……………………………………….. (Date) ……………………………………………...………….. (Name of Supervisor (if relevant)) ……………………………………….. 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