[title of project/thesis][title of project/thesis]

Your nameYour name

Project or Thesis (select one)Project or Thesis (select one)

Identify the “larger” problemIdentify the “larger” problem

This study looks at:This study looks at:The research question is:The research question is:Hypothesis/es (if any) is/are:Hypothesis/es (if any) is/are:

Describe Proposed Method Describe Proposed Method (should inform issue of human (should inform issue of human

subjects)subjects)SampleSampleNature of dataNature of dataWhere you will obtain dataWhere you will obtain dataWhat you will do to collect dataWhat you will do to collect data

Human Subjects ConcernsHuman Subjects ConcernsNeed University Review? Yes or Need University Review? Yes or

NoNo ConfidentialityConfidentiality VulnerabilityVulnerability Informed ConsentInformed Consent