Researcher Registration Form

First Name: *

Last Name: *

Student ID: *

Phone:

Email: *

Course No/Name of Program: *

Course Instructor/Supervisor: *

Permission given by Course Instructor/REB Approval Date:

If your study has not been approved, please tell us the date you submit your proposal.

REB Approval Code

Group Name

Please give us your group name that you use on Qualtrics.

Title of Study: *

URL of the research study

Please give us the website that you create for data collection if it is ready.

Last Date to Collect Data: *

Length of Each Session: *

How long does it take to complete the research study?

Minimum Number of Participants Required:

Consent Form:

Debriefing Form:

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