Supervising Teacher or Scientist Additional Approval Forms
Alabama Science Scholar Search and Gorgas Scholarship Competition
INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL FORM*
FOR PROJECTS INVOLVING HUMAN PARTICIPANTS
The rules for these projects are published in the Rules & Regulations booklet at https://student.societyforscience.org/international-rules-pre-college-science-research
Student’s Name_____________________________________________
Student’s High School _______________________________________
Name, address and telephone number of institution providing approval: _________________________________________________________
A. Explain why human subjects are proposed or necessary for this project.
B. Describe and assess any potential risk (physical, psychological, social, legal, or other).
C. Describe consent procedures to be followed and attach a sample of the completed Informed
Consent Form used or £ check here if not applicable
D. Describe procedures to minimize risks.
E. Describe benefits to the individual or society.
F. Explain how the benefits exceed the risks.
G. Approved by Institutional Review Board (IRB) (To be completed by the IRB prior to experimentation; a minimum of 3 members required, one science teacher, one health related professional and one administrator)
£ No more than minimal risk involved
£ More than minimal risk involved (Informed Consent Statements required)
* If the institution approving this project has a different form that contains essentially this same information, the institution’s form may be used.
a. Scientist/Science Teacher:
b. Physician/Psychiatrist/Physician’s Assistant/Licensed Psychologist/Registered
Nurse/Licensed Social Worker/PharmD: (circle one)
c. School Administrator (preferably Principal or Vice Principal):
______________________________________________________________________________
Member of IRB’s Printed Name Signature Date of Approval
______________________________________________________________________________
Member of IRB’s Printed Name Signature Date of Approval
______________________________________________________________________________Member of IRB’s Printed Name Signature Date of Approval