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Request to Conduct Research
This form must be completed prior to approval being granted to conduct research in Mt. Diablo Unified School District.
Email *
Title of the Study/Project *
Person requesting to engage in research in Mt. Diablo USD. *
Organization/School sponsoring the research project. *
Has the project been approved by your Institution's IRB? If not, when do you expect approval? *
Research Agency Contact Person *
Research Agency Street Address *
Does this project involve a survey or interview? If so, with whom?
Students
Staff
Families/Parents
Community Members
Other
Surveys
Interviews
Observations
Document Review
Other
How much time will the individual research subjects be asked to commit and over which time period (for example, one hour weekly for three weeks) *
Please describe in detail the type and format of the data you are requesting.   *
Identify names of individuals who will have direct contact with students. If approved, background verification/fingerprinting and a District Volunteer Application must be filed for each individual. *
Will the results be presented in a manner that may allow identification of individual school, staff or students? *
How will the requested data be used? *
Please share how you think this research will support Mt. Diablo Unified and/or its students, staff or families.
A copy of your responses will be emailed to .
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