Columbus City Schools Research Project Request Form

Columbus City Schools

Research Project Request Form

This form should be completed by anyone desiring to conduct research with Columbus City School (CCS) employees and/or students. Current CCS Employees should complete this form and gain approval by the school principal prior to starting research activities at the school.

SECTION A: RESEARCHER INFORMATION

Name of Researcher:*

Researcher Email Address:*

Researcher Secondary Email Address:*

Researcher Phone Number:*

Affiliated University:

Currently employed with Columbus City Schools?*

Select or enter value

Position*

Include school name or department and your position title.

Advisor Name, if applicable:

Advisor Email Address:

Advisor Phone Number:

Additional Researchers Involved in This Project:

Please include name, email, and phone number for each.

SECTION B: RESEARCH PROJECT

Title of Research Project / Study:*

Does this research project have a CCS sponsor?*

Select or enter value

Note: Sponsors should be aware that they are being named as a sponsor.

CCS Sponsor Name:

CCS Sponsor Email:

Do you have IRB approval from your institution?*

Select

Please attach your IRB approval letter to this submission. If IRB approval is conditional on CCS approval, graduate student researchers may attach a letter of support from a dissertation committee chair on university letterhead; others may attach a letter of support from a supervisor.

IRB Expiration Date:*

Application Type:*

Select

Unique identifier for the associated study:

The research is related to a:*

Select or enter value

If Professional Project: Please describe: *

Type of Study:*

Select

Other: Please specify.*

For program evaluations, please attach a logic model, theory of change, and/or evaluation plan.

Type of Data:*

Select

Statement of problem and research question(s):*

Subjects or population for the study:*

Example: SY 2022-23 3rd graders that failed OST ELA future matriculation rate.

Projected Start Date:*

Please select a start date at least one month in the future.

Estimated Projected Completion Date:*

Anticipated Data Destruction Date:

Important:

All researchers must:

a) adhere to District policies, administrative guidelines and procedures as well as applicable laws and regulations, including but not limited to FERPA and ORC 3319.321 as they relate to confidentiality of records and the release of personally identifiable student information,

b) adequately inform study participants, including students and/or parents, and school staff of the purpose of the study and clearly articulate that participation is voluntary,

c) contact participants only as specified in the approved research proposal and comply with CCS visitor policies, and

d) protect the rights and welfare of all human subjects.

e) have their institution’s IRB approval prior to requesting support from their principal.

f) submit a report of their results within 30 days of completing their final write-up of the research and present their findings to the Columbus City Schools Research Review Board at the conclusion of the study.

By submitting this application, researchers agree to hold harmless Columbus City Schools Board of Education and its employees, students, parents, and any other research participants from any and all claims, liability, damages, acts, and/ or omissions that may arise from or be related to this research project.

Please attach the following documents to this application in the file upload field below:

1) The complete research proposal.

2) Recruitment Materials

3) Instruments and Protocols for Data Collection

4) Consent/Assent Forms

5) For Program Evaluations: Logic Model, Theory of Change, and/or Evaluation Plan

6) For Secondary Data Requests: a sample spreadsheet with a column for each data element you are requesting

7) IRB approval letter (If IRB approval is conditional on CCS approval, graduate student researchers may attach a letter of support from a dissertation committee chair on university letterhead; others may attach a letter of support from a supervisor.)

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