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* 1. Contact Information

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* 2. Which of the following most accurately describes you?

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* 3. What is your affiliation with DVC?

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* 4. Please name any other institutions to whom you have reached out to conduct this research. Input N/A if DVC is the only institution. 

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* 5. Title of study

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* 6. What are your research project's intended start and end dates? How will the study take participants to complete? 

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* 7. What is/are your research question(s)? What would you like to know?

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* 8. Please select the participants of your research. Check all that apply.

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* 9. Describe the methodology for your research. What will participants be doing in your study (e.g., taking a survey, participating in an experiment or focus group, etc.)? Please describe all surveys and materials (e.g., videos, images) that participants will encounter, and upload these in Question 10.

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* 10. Upload or provide a link to your survey or interview questions and other research materials (e.g., videos, photos, etc.) described in Question 10.

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* 11. . Do you have a direct contact at DVC who will be assisting with this research?

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* 12. Describe how you plan to recruit participants for your research. If you will be offering an incentive to participants, please describe.

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* 13. DVC is actively committed to educational excellence, and achieving greater equity, diversity, and inclusion within institutional practices. We have current interest in work related to racial equity, closing achievement gaps for student success, increasing degree/certificate achievement across student populations, and enrollment. In what way does your research align with these goals? 

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* 14. Describe all known risks and discomforts associated with study procedures, whether physical, psychological, economic or social (e.g., pain, stress, invasion of privacy, breach of confidentiality), noting the likelihood and degree of potential harm and measures taken to minimize risks and discomforts to participants. Include in your description how you will de-identfy the students in your reporting to ensure student confidentiality. 

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* 15. We have students who are under 18 years of age. If your research involves students, what is your plan for removing underaged students from participants in this study?

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* 16. Will this information be used for a commercial endeavor?

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* 17. Has your research been approved by an Institutional Review Board (IRB) at another institute?
(If yes, please upload your IRB approval from your home institution in Question 18. If no, use the comment box to describe what steps you have taken to maintain research integrity and ensure participant safety and respect.)

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* 18. If applicable, upload a copy of IRB approval received from another institution.

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* 19. After you have completed your research, how will you share your findings with DVC? Examples: Making a brief presentation to the Research, Planning, Evaluation Committee; sharing a brief summary report of the findings; providing a copy of the completed report.

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