Request for Permission to Conduct Research at the RVTTI

Request for Permission
to Conduct Research at the RVTTI
1. Name of Principal Investigator:______________________________________________
2. Institutional Affiliation: ____________________________________________________
3. Degree/Diploma Sought (if applicable)________________________________________
4. Mailing /Email Address:____________________________________________________
5. Phone:__________________________________________________________________
6. Category of Research: Indicate the type and form of research to be conducted (e.g., interviews,
survey)________________________________________________________
________________________________________________________________________
7. Research Subjects: Indicate from whom data will be collected (e.g., lecturers, students, nonteaching staff, documents)
_______________________________________________________________________
8. Has your research proposal been approved by your university's unit responsible for ensuring
compliance with regulations governing research involving human subjects? _____ Yes ____ No
(attach a copy of the approval to this form).
9. State the title of research/project:
10. Purpose (briefly identify the purpose[s] of your study): ___________________________
________________________________________________________________________
11. Why is it important or necessary to conduct your research at RVTTI?
________________________________________________________________________
________________________________________________________________________
12. What are the timelines for administering your research? __________________________
13. When and where do you anticipate reporting the results of your research?
________________________________________________________________________
CONDITIONS FOR MAINTAINING ETHICS AND SHARING PROJECT RESULTS
I agree to maintain the anonymity of individual students, staff members and RVTTI in
any report(s) and in any publication(s), e.g., journal article(s), book(s), etc., which
incorporate any information derived from the research conducted within RVTTI.
I agree that if information about subjects is disclosed, including personal
characteristics and confidential data concerning RVTTI during research, I ensure that
they will not be at risk for damage to their financial standing, employability, or
reputation
I agree that this study does not involve deception (i.e., withholding from or giving false
or misleading information to subjects/institution)
I agree that the procedures do not cause any degree of discomfort, harassment, invasion
of privacy, risk of physical injury, threaten the dignity or otherwise potentially harm
subjects/institute.
I agree to provide the Office of Research and Development with the research results,
complete documentation and information on the location of the complete research and,
in the future, subsequent publications.
Signature of the Researcher ………………………………
Date ……………………..
Instructions: Attach a copy of cover letter, the research instruments, consent form, debriefing
statement (if research involves deception) and NACOSTI approval to this form.
Send all materials to: Research and Development Coordinator
RVTTI, P O BOX 244-30100, ELDORET
Or email to: [email protected] & [email protected]