Research Project Request Form
The Iron County School District recognizes good research as a building block for improving education.  Priority is given to projects that:
  • Yield useful products or data for our schools
  • Align with District mission, vision, values and goals
  • Are conducted by ICSD staff in pursuit of advanced degrees
  • Are not intrusive or do not interrupt classroom or school activities
Other factors that influence the decision to approve a research project include:
  • Timing (i.e., project occurs in the last quarter of the school year)
  • Conflict with other research projects
  • Volume of already approved research activities
Your application will not be complete until this form is completed AND your research proposal with the accompanying documents and IRB approval (or documentation that the IRB approval is pending) is emailed to lance.hatch@ironschools.org.  
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Email *
Investigator/researcher name *
Mailing Address
Phone/cell
Email address *
Project Title
College, university or institution sponsoring this project or to which the investigator is affiliated.
Type of affiliation with the institution listed above
Clear selection
College/Department
This project is in partial fulfillment of the requirements for:
Name of Project Director/Advisor/Supervisor 
Title of Project Director/Advisor/Supervisor
Institution of the Project Director/Advisor/Supervisor
Email Address of the Project Director/Advisor/Supervisor
Project Funding
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General project purpose and description
Outline of procedure
Description of student subjects (if applicable)
Description of staff subjects (if applicable)
Description of parent subjects (if applicable)
Benefits of the project
Risks of the project
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Check all that apply
If the project does not require the approval of an IRB, please explain.
Investigator Assurances : 

1. To adhere to the procedures of the project as approved by the District. Any changes to procedure must receive prior approval. 

2. To furnish the District with progress reports upon request. 

3. To provide the District with one copy of all publications, including dissertations, reports, summaries, articles, and papers, resulting the completed project. 

4. The investigator gives permission for the District to cite the ongoing or completed project in its own publications, with credit to the investigator(s). 

5. Prior to the circulation of any report of research findings or conclusions in connection with this study, the District will have the final approval of the use of its name or references to the District, its staff, or its programs. 

6. To comply with the Family Educational Rights and Privacy Act and amendments thereto. And, to comply with all applicable regulations and customary practices pertaining to participant privacy, and the security of personally identifiable information. 

7. To comply with Federal regulations and recognized professional practices relative to the protection of human subjects in research studies. 

8. To report only aggregate data or pseudonyms in such a way so that information cannot be traced directly or by inference to a specific community neighborhood, staff member, student, family member of a student, or school attended. 

9. To secure all data, including, audio and video recordings, electronic/digital data, and documents; and restrict access to the data to individuals approved in the application. 

10. To destroy all materials gathered which contain personally identifiable information after the purposes for which the material was gathered have been completed. Failure to do so may subject investigator(s) to criminal prosecution.
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Attach documentation (forms, tools, etc...)
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A copy of your responses will be emailed to the address you provided.
Submit
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