Ethical Clearance Application Form

Research Ethics Review Committee — Salaam University

Fields marked with * are required. The serial number and ethical clearance number will be assigned by the committee office.

Section 1 — Research Topic

Research Title *

Section 2 — Principal Investigator

Full Name *

Department / Institution *

Email Address *

Phone / Contact Number

Section 3 — Co-Investigator(s)

Co-Investigators (optional)

Section 4 — Summary of Research Proposal

Research Summary *

0 / 100 min

Section 5 — Data Collection Instruments

Indicate the type(s) of data collection instruments and provide details

Instruments Details

Section 6 — Human Subjects

Description of Human Subjects *

Estimated Number of Participants *

Age Group(s) *

Vulnerable Participants?

No Yes

Recruitment Method *

Consent Process *

Section 7 — Declaration

I declare that the information provided in this application is accurate and complete to the best of my knowledge. I understand that the proposed research involving human participants will be conducted in accordance with applicable ethical standards and institutional requirements. I will obtain the required ethical approval before commencing data collection involving human subjects.

I agree to the above declaration and confirm that all information provided is accurate