BOX FOR HSRC OFFICE ONLY
Central Washington University
REQUEST FOR COURSE PROJECT HSRC EXEMPTION
HSRC APPLICATION NUMBER:
FOR INSTRUCTORS SUPERVISING COURSE PROJECTS
HSRC Office
400 East University Way
Ellensburg WA 98926-7401
Black Hall, Room 225-17
Mail Stop 7401
(509) 963-3115
Fax: (509) 963-1064

HUMAN SUBJECT REVIEW COUNCIL SIGNATURE
DATE
Period of certification is for no more than two years. Certified from
CERTIFIED
EXEMPT

DISAPPROVED
through
THIS CERTIFICATION IS VALID AS LONG AS THE PARAMETERS OUTLINED BELOW DO NOT
CHANGE FOR THE LISTED COURSE. (If changes are requested, a Project Modification Request Form must be submitted
and approved.)
This application is to be used by CWU faculty (For department chairs or program directors, please see note in signature box on page 2):

who teach classes where research practice occurs;

whose class projects for students involve similar methods, recruitment, and data; and

the parameters as outlined in item 2 below stay within the federal, state, and university guidelines for exemption from HSRC minimal risk
or full review.
Application must be made prior to the recruitment of subjects. Approval will be valid for a period of no more than two years as long as
class projects stay within the approved parameters outlined below. (Refer to page 2 of this application for guidelines and examples; additionally
guidance can be found in the CWU Guidelines for Student Research and Class Projects.) We realize it is difficult to have one form fit all
circumstances; therefore, we encourage you to contact the HSRC administrator with your questions or particular needs at 963-3115.
NAME:
CWU TITLE:
DEPARTMENT:
MAIL STOP:
COURSE FOR WHICH THIS APPLICATION APPLIES:
Course Catalog Number:
1.
PHONE:
E-MAIL:
Course Title:
CATEGORIES UNDER WHICH THESE CLASS PROJECTS QUALIFY FOR EXEMPTION (Refer to Page 2 for a description of
categories and examples):
Survey/interview/observation of public behavior*
Taste and food quality studies
Normal educational research conducted in typical
educational settings
*Note: If using an Internet survey, see Internet Research Issues
2.
PARAMETERS UNDER WHICH STUDENT PROJECTS WILL BE CONDUCTED. Briefly describe parameters for : (a) subject age and
recruitment; (b) what participants will do (if applicable); (c) the nature of the data to be obtained; (d) informed consent; and (e) how
anonymity or confidentiality will be maintained. [Please attach additional pages, as necessary.]
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Note to department chairs and program directors: If chairs or directors wish to use this form to cover several instructors teaching the course
listed on page one, then consult with each instructor about the course parameters. Attach to this form multiple signature pages, one for each
instructor for whom this application applies. Within the approval period, the faculty list may be increased, as needed, by sending signature pages
from each new instructor together with a copy of the first page of the original application to the HSRC Office at Mail Stop 7401. All additional
instructors must have an opportunity to review page one of the original application and must abide by the set parameters outlined there. If the
parameters are changed for the course, a new Faculty Request for Exemption will be required.
3.
SIGNATURE. I understand that the information provided on this form is correct and that the class projects will be conducted in
accord with the general principles stated in the CWU Human Subjects Procedures Manual. By checking each of the boxes, I agree to
the following:
I believe the parameters outlined above stay within the federal, state, and university guidelines for exemption from HSRC
minimal risk or full review. (Consult with HSRC Office when necessary.)
As faculty sponsor of student research practica, I have completed the Responsible Conduct of Research (RCR) training,
available online at Online Training or a CWU sponsored RCR workshop. I have attached the training certificate of completion
to this form or I already have this on file in the HSRC office.
As faculty sponsor of student research practica, I understand that I am responsible for seeing that federal as well as disciplinary
(e.g., APA, OHA, etc.) ethical standards of human subject research will be followed.
If a student project becomes research (see CWU Guidelines for Student Research and Class Projects), I understand that the
student, as principal investigator of the project/research, must submit an individual Request for Exemption for HSRC review
and approval before public dissemination of the data (presentations, publications, use outside the classroom) will be permitted. I
will advise and guide the student through this process.
FACULTY PRINTED NAME
DEPARTMENT / PROGRAM
FACULTY SIGNATURE
DATE
GUIDELINES
CATEGORIES FOR EXEMPTION
The following guidelines are provided to aid faculty in determining the category or categories of exemption for which this application applies.
Examples are provided for clarification.

Educational research in educational setting
Research involving normal educational practices in a typical setting may be exempt. The key words here are normal and typical.
Example which would be exempt:
― A teacher, student teacher, or school counseling intern interviews her students to assess the effectiveness of a new reading
program.
(Additional examples are continued on page 3.)
Examples which would not be exempt:
― A CWU student researcher interviews middle school students to assess the effectiveness of a new reading program. (This is
not exempt because it is not a normal educational practice for an outside researcher to interview students about an educational
program.)
― A teacher surveys her students in the classroom about their after-school activities. (The setting is typical but the activity is
not normal educational practice.)
Revised 25Feb2013
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

Surveys/interviews/observation of public behavior
Research in this category is exempt when participants cannot be identified ― directly, demographically or statistically ― or the
responses/public observations could not harm participants if made public. Special restrictions apply to subjects from vulnerable
populations: children, prisoners, those incompetent to provide informed consent, etc. For example, federal regulations do not allow
exemptions for research involving surveys or interviews with children nor any research involving prisoners, including parolees.
Furthermore, while passive observation of children is exempt, observation of children when the researcher is a participant is not exempt.
Because of the nuances of the law, please consult HSRC for further guidance.
Examples which could be exempt:
― Observation of adults’ or children’s buying habits in a local McDonald’s restaurant (no-risk data, passive observations of adults and
children in public setting)
― Oral history interview of an adult that follows the Oral History Association (OHA) guidelines
― Surveying CWU adult students about satisfaction with dining services (no-risk data, survey of adults)
― Passively observing with pencil and paper the interaction of children with fathers at a public park (passive public observations, no
identifiers)
Note: Surveying adults with personal or probing questions may be exempt, by federal regulations, if identifiers are not linked to the
record; however, it is highly recommended that professors avoid student projects that introduce a level of risk and discomfort to the
participant. If such projects become research even though initiated as part of a student learning activity, the HSRC review will require a
careful examination of the informed consent process, survey procedures, and issues of anonymity/confidentiality.
Examples which would not be exempt:
― Surveying high school students about their eating behavior (surveying minors― not exempt)
― Surveying college students’ drug and alcohol habits with considerable demographics collected (potentially harmful and
unlawful information collected, could be minors in the subject pool, demographics may allow identification)
― Videotaping music practice sessions with teacher for research purposes (identifiers, risk of embarrassment or discomfort)
Note: In general, videotaping allows identification and introduces risk which requires a higher level of HSRC review.
― Observing the conduct of middle school student while interacting with them in a group game (participatory observation of
children is not exempt)

Taste and food quality studies
Food research to evaluate quality, taste, or consumer acceptance is exemptible if the food is wholesome (has no additives) or the food is
Generally Recognized As Safe (GRAS).
Examples which would be exempt:
― Taste test involving different regionally grown grapefruit (wholesome food)
― Taste and consumer acceptance test of cake mix using prune whip as a fat substitute (Prune whip is certified safe as a food
additive at levels used as fat substitute in cake mix.)
― Taste test if a food is consumed that contains a food ingredient within the Tolerable Upper Intake Level (UL) established
by the federal government or is Generally Recognized as Safe GRAS).
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