SOUTHERN ADVENTIST UNIVERSITY — INSTITUTIONAL REVIEW BOARD
FORM C
APPLICATION TO CONDUCT STUDENT CLASS PROJECTS
For IRB Use Only:
Tracking Number ________________
Date Submitted ________________
Date Approved __________________
Instructor’s Assurance: By submitting this application, I attest that I am aware of the applicable principles,
policies, regulations, and laws governing the protection of human subjects in research and that I will ensure that
all student projects adhere to these principles.
This form should not be used if your student research involves any level of risk to human subjects. Also, please
refer to the HIPAA section for the appropriate forms. Research involving risk must use the routine IRB review
procedures.
Provide the required information in the space available. If additional space is needed, attach a separate sheet or
expand that section of the form. Both scanned original signatures and typed electronic signatures are
acceptable. Please submit the class syllabus or research assignment and a copy of your related CITI training
certificate at the same time as the application. This form must be approved by the IRB Chair or his/her
designee prior to starting any student projects. Please try to allow at least one week for approval.
All forms should be submitted by email to irb@southern.edu.
Title of Class:
Instructor:
Semester:
Title of Class:
Instructor:
Semester:
Title of Class:
Instructor:
Semester:
Title of Class:
Instructor:
Semester:
Please turn page over and complete form.
SOUTHERN ADVENTIST UNIVERSITY — INSTITUTIONAL REVIEW BOARD
As instructor of this class I certify that the class projects outlined in this form meet the following criteria:
(All criteria are mandatory, so all items must be initialed.)
_____ This assignment is part of a class and is conducted under my faculty supervision.
_____ The purpose of this assignment is for students to learn about the process of engaging in research or
applying a pedagogical technique as opposed to engaging in research which is intended to be used for
publication, formal reports, or presentations at professional conferences. Please attach each class
syllabus.
_____ The CITI training is listed as a class assignment in my syllabus and credit is given for completing it.
_____ These projects are eligible for exempt or expedited review. No research project(s) requiring full board
approval may be approved using this procedure.
_____ The instructor has completed any related on-line CITI training and has filed their certificate of
completion with the Chair of the IRB Committee.
_____ The instructor will require each student to submit the appropriate Form A to the instructor for approval
prior to engaging in their research assignment. The IRB does not need to see these forms.
_____ The instructor will fill out Form D prior to the research start-up.
_____ The instructor will fill out Form E at the termination of the research project (must be within one year or
must be renewed.
These files must be maintained for no less than three years by the faculty member and may be periodically
audited by the IRB Chair and/or his/her designee.
________________________________________________
Instructor Signature
____________________________
Date