Institutional Review Board (IRB) Project Approval Request

The Institutional Review Board at Lower Columbia College is charged with upholding LCC Policy Number 320: Policy for the Protection of Human Subjects. Individuals who desire to conduct research of any kind within the context of the institution (including but not limited to involvement of LCC students, employees, or facilities) must receive approval from the Institutional Review Board before proceeding.

Your submission must include:

Title of project.
Method of proposed research (survey, focus group, etc.)
Description of project (including but not limited to a statement regarding the purpose of the project).
Description of your data collection method, including how you intend to protect the confidentiality of your subjects and the integrity of your data.
Script or introduction that will be used to describe the project to participants.
Intended sample size.
Intended population that you will be attempting to infer to (for example, LCC student body, Cowlitz County, etc.), if applicable.
Statistical methods or tests you plan to use (if this is not applicable, please include that information).
The instrument in its entirety (questions or prompts you plan to use)

Project Submission (Upload a file)*

I hereby acknowledge that I have read LCC policy 320 regarding Protection of Human Subjects.*

I Acknowledge

I agree to comply fully with Lower Columbia College's Policy for the Protection of Human Subjects in conducting my project, including maximizing benefits and minimizing risk to each participant (minimizing risk includes keeping responses confidential and not asking respondents to disclose anything that could put them at risk for criminal or civil liability, or anything that could be damaging to their financial standing, employability, reputation, or well-being).*

I Agree

I understand that my project cannot involve subjects under the age of 18 without first obtaining written consent from a parent or guardian.*

I understand

I understand that any changes to my instrument (questions or prompts you plan to use) must be approved by the IRB.*

I understand

Title of Project*

Name (typing name constitues e-signature)*

Date*

MonthDayYear

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Note: LCC students requesting approval must include faculty permission either via signature on this form or separate email confirmation to the IRB chair. Requests submitted without faculty permission will not be considered.

Lower Columbia College does not discriminate on the basis of sex and prohibits sex discrimination in any education program or activity that it operates, as required by Title IX, including in admission and employment. Lower Columbia College provides equal opportunity in education and employment and does not discriminate on the basis of race, color, national origin, citizenship or immigration status, age, perceived or actual physical or mental disability, pregnancy, genetic information, sex, sexual orientation, gender identity, marital status, creed, religion, veteran or military status, or use of a trained guide dog or service animal as required by Title VI of the Civil Rights Act of 1964, Title VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, Sections 504 and 508 of the Rehabilitation Act of 1973, the Americans with Disabilities Act and ADA Amendment Act, the Age Discrimination Act of 1975, the Violence Against Women Reauthorization Act and Washington State's Law Against Discrimination, Chapter 49.60 RCW and their implementing regulations. All inquiries regarding compliance with Title IX, access, equal opportunity and/or grievance procedures should be directed to Vice President of Foundation, HR & Legal Affairs, 1600 Maple Street, PO Box 3010, Longview, WA 98632, title9@lowercolumbia.edu, Phone number, (360) 442-2120, Phone number/TTY (800) 833-6388. The notice of nondiscrimination is located at https://lowercolumbia.edu/disclosure/non-discrimination/.