ࡱ> OQ!LMNu bjbj~~ ކdgdgyL & r r r D 6!|$| .)v 555B'b>ebyb acccccc$8r b^'bbb225Bmimimib25r Bamibamimi2)B0ş5 puc.M0ef\şş0r XbbmibbbbbgPbbbbbbbbbbbbbbbbX : For Office Use Only Ref. NumberAssigned Reviewers Outcome  CONTROL Forms.CheckBox.1 \s  Granted  CONTROL Forms.CheckBox.1 \s  Amendments  CONTROL Forms.CheckBox.1 \s  Rejected APPLICATION FOR ETHICAL APPROVAL FOR A RESEARCH PROJECT This is an application form for ethical approval to undertake a piece of research. Ethical approval must be gained for any piece of research to be undertaken by any student or member of staff of ֱ. Approval must also be gained by any external researcher who wishes to use Queen Margaret students or staff as participants in their research. Please note, before any requests for volunteers can be distributed, through the moderator service, or externally, this form MUST be submitted (completed, with signatures) to the Secretary to the Research Ethics Panel ( HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk). You should read ֱs chapter on Research Ethics: Regulations, Procedures, and Guidelines before completing the form. This is available at:  HYPERLINK "http://www.qmu.ac.uk/quality/rs/default.htm" http://www.qmu.ac.uk/quality/rs/default.htm The person who completes this form (the applicant) will normally be the Principal Investigator (in the case of staff research) or the student (in the case of student research). In other cases of collaborative research, e.g. an undergraduate group project, one member should be given responsibility for applying for ethical approval. For class exercises involving research, the module coordinator should complete the application and secure approval. The completed form should be typed rather than handwritten. Electronic signatures should be used and the form should be submitted electronically. Checklist: Documents enclosed with application: Please note that any application with missing relevant documentation will be returned to the applicant. Enclosed (please tick)Not applicable (please tick)Document name CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Research protocol or proposal CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Participant Information Sheet(s) (PIS) CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Participant consent form(s) CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Copies of recruitment advertisement material CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Sample questionnaires (please detail below) CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Interview schedules or topic guides CONTROL Forms.CheckBox.1 \s   CONTROL Forms.CheckBox.1 \s Letter(s) of support from any external organisations involved in the research CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s If interacting with potentially vulnerable groups, please provide the following information for checks by authorised personnel: PVG Membership No: Disclosure Number (unique to each certificate): Date of issue: CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Risk assessment documentation CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s Any other documentation (please detail below) Section A: Applicant details Researchers name: Post: Qualifications: Contact email: Category of researcher (please tick and enter title of programme of study as appropriate):  CONTROL Forms.CheckBox.1 \s ֱ undergraduate studentTitle of programme: CONTROL Forms.CheckBox.1 \s ֱ postgraduate student taught degreeTitle of programme: CONTROL Forms.CheckBox.1 \s ֱ postgraduate student research degree CONTROL Forms.CheckBox.1 \s ֱ staff member research degree CONTROL Forms.CheckBox.1 \s ֱ staff member other research CONTROL Forms.CheckBox.1 \s Other (please specify) Details: School: Division: Subject area: Name of Supervisor or Director of Studies (if applicable): Names and affiliations of all other researchers who will be working on the project: First nameLast namePositionAffiliationRole on project Section B: Research details Title of study: Expected start date: Expected end date: Protocol or proposal version: (please follow naming format short_title_yyyymmdd_version_number) Protocol date: Details of any grants/funding/financial support for the project from within/outside ֱ: Do you plan at any stage of the project to undertake research involving adults lacking capacity to consent for themselves?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No Answer Yes if you plan to recruit living participants aged 16 or over who lack capacity, or to retain them in the study following loss of capacity. If you answered yes, please refer to the online training module by University of Leicester and University of Bristol on Adults lacking capacity to consent for research for further information:  HYPERLINK "https://connect.le.ac.uk/alctoolkit/" https://connect.le.ac.uk/alctoolkit/ Your research may require approval by an authorised Research Ethics Committee (e.g. NHS Research Ethics Committee).If in doubt, please contact ֱ Research Ethics Panel for further advice ( HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk). Do you plan to include any participants who are children?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No Answer Yes if you plan to recruit participants aged under 16. Please also ensure that question F6 is answered. Do you plan at any stage of the project to work with human tissue samples (or other human biological samples) and data?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to question B9, please also ensure that Section G is completed. To obtain a copy of Section G, please email  HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk. Section C: Overview of the research Summary of the study. Please provide a brief summary of the research (maximum 300 words) using language easily understood by lay reviewers and members of the public. Please note that this summary may be published in the public domain.  Summary of main issues. Please summarise the main ethical, legal, or management issues arising from your study and say how you have addressed them. Not all studies will raise significant issues. Some studies may have straightforward ethical or other issues that can be identified and managed routinely. Others may present significant issues requiring further consideration by other review bodies (as appropriate to the issue).Studies that present a minimal risk to participants may raise complex organisational or legal issues. You should try to consider all the types of issues that the different reviewers may need to consider. What is the principal research question/objective/aim? Please put this in language comprehensible to a lay person.  What are the secondary research questions/objectives/aims if applicable? Please put this in language comprehensible to a lay person.  What is the academic/scientific justification for the research? Please put this in language comprehensible to a lay person.  Section D: Design and Methodology Research procedures to be used: please tick all that apply. Tick if applicable CONTROL Forms.CheckBox.1 \s Questionnaires (please attach copies of all questionnaires to be used)  CONTROL Forms.CheckBox.1 \s Interviews (please attach summary of topics or interview schedule to be explored)  CONTROL Forms.CheckBox.1 \s Focus groups (please attach summary of topics or interview schedule to be explored / copies of materials to be used)  CONTROL Forms.CheckBox.1 \s Experimental / Laboratory techniques (please include full details under question D2)  CONTROL Forms.CheckBox.1 \s Use of email / internet as a means of data collection (please include full details under question D2)  CONTROL Forms.CheckBox.1 \s Use of materials that are subject to copyright (please include full details under question D2 and confirm that the materials have been / will be purchased for your use)  CONTROL Forms.CheckBox.1 \s Use of biomedical procedures to obtain human tissues (or other biological materials) (please include full details under question D2 and Section G. Also include subject area risk assessment forms, where appropriate) CONTROL Forms.CheckBox.1 \s Other technique / procedure (please include full details under question D2)  Please summarise your design and methodology. It should be clear exactly what will happen to the research participant for research involving human participants. Please complete this section in language comprehensible to the lay person. Do not simply reproduce or refer to the protocol.  Does your research include the use of people as participants?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No Answer No if your project involves secondary analysis of collected data. If you answered Yes to question D3, please ensure that Section F is completed. Does your research include the experimental use of live animals?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to question D4, please note that the university is not insured to experiment on live animals. Please attach the insurance coverage certificate to this application for review. Please check and ensure that appropriate university insurance is in place to cover the work. If in doubt, please contact Karen Sinclair (Head of Finance,  HYPERLINK "mailto:ksinclair@qmu.ac.uk" ksinclair@qmu.ac.uk ) on insurance coverage. Does your research involve experimenting on plant or animal matter, or inorganic matter?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to question D5, please check and ensure that appropriate university insurance is in place to cover the work. If in doubt, please contact Karen Sinclair (Head of Finance,  HYPERLINK "mailto:ksinclair@qmu.ac.uk" ksinclair@qmu.ac.uk ) on insurance coverage. Please attach the insurance coverage certificate to this application for review. Does your research include the analysis of documents, or of material in non-print media, other than those which are freely available for public access?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to Question D6, give a description of the material you intend to use. Describe its ownership, your rights of access to it, the permissions required to access it and any ways in which personal identities might be revealed or personal information might be disclosed. Describe any measures you will take to safeguard the anonymity of sources, where this is relevant:  Will any restriction be placed on the publication of results?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to question D7, give details and provide a reasoned justification for the restrictions. (See Research Ethics Guidelines Section 2, paragraph 7)  Who will have access to participants personal data during the study? Where access is by individuals outside the research team or direct care team (health research), please justify and say whether consent will be sought.  How long will personal or personally identifiable data be stored or accessed after the study has ended? Please note this question only relates to retention of personal or personally identifiable data.  CONTROL Forms.CheckBox.1 \s  Less than 3 months  CONTROL Forms.CheckBox.1 \s  3 6 months  CONTROL Forms.CheckBox.1 \s  6 - 12 months  CONTROL Forms.CheckBox.1 \s  12 months 3 years  CONTROL Forms.CheckBox.1 \s  Over 3 years It is recommended that data containing personal details that would lead to the identification of participants should be destroyed as soon as possible. Examples of personally identifiable data include participants email addresses, NHS/CHI numbers, expressions of interest etc., BUT NOT consent forms. Personally identifiable data should be stored separate from the anonymised data to prevent linkage. If potential participants have provided you with their contact details, this information should only be retained until they have consented or refused to participate in the research. However, if a participant noted that they would like to receive a summary of the research, it would be appropriate to retain their contact details until this summary has been sent out. See the following for advice on data handling:  HYPERLINK "http://www.lancaster.ac.uk/shm/study/doctoral_study/dclinpsy/onlinehandbook/ethics_and_data_storage_advice/" http://www.lancaster.ac.uk/shm/study/doctoral_study/dclinpsy/onlinehandbook/ethics_and_data_storage_advice/ For how long will you store research data generated by the study? State if the data will be stored for an infinite time period. Please give details of the short term (duration of project) and long term (after project completion) arrangements for storage of research data after the study has ended. (See Research Ethics Guidelines has Section 1, paragraph 2.4.1) Short term storage of research data on any of the following:  CONTROL Forms.CheckBox.1  Manual files (includes paper or film)  CONTROL Forms.CheckBox.1  Home or other personal computers  CONTROL Forms.CheckBox.1  University computers/server  CONTROL Forms.CheckBox.1  Laptop computers  CONTROL Forms.CheckBox.1  Hard drive storage  CONTROL Forms.CheckBox.1  USB storage devices  CONTROL Forms.CheckBox.1  Other portable storage (e.g. CDs, DVDs etc.)  CONTROL Forms.CheckBox.1  Cloud/online storage (please provide name and server location of cloud storage below)  CONTROL Forms.CheckBox.1  Others (please state): Say where data will be stored, who will have access and the arrangements to ensure security (for example, encryption used). Explain how and when data will be destroyed (if applicable).  Long term storage of research data on any of the following:  CONTROL Forms.CheckBox.1  Manual files (includes paper or film)  CONTROL Forms.CheckBox.1  Home or other personal computers  CONTROL Forms.CheckBox.1  University computers/server  CONTROL Forms.CheckBox.1  Laptop computers  CONTROL Forms.CheckBox.1  Hard drive storage  CONTROL Forms.CheckBox.1  USB storage devices  CONTROL Forms.CheckBox.1  Other portable storage (e.g. CDs, DVDs etc.)  CONTROL Forms.CheckBox.1  Cloud/online storage (please provide name and server location of cloud storage below)  CONTROL Forms.CheckBox.1  eData ֱ open access data repository  CONTROL Forms.CheckBox.1  Others (please state): Say where data will be stored, who will have access and the arrangements to ensure security (for example, encryption used). Explain how and when data will be destroyed (if applicable).  Will the data be stored:  CONTROL Forms.CheckBox.1 \s  In fully anonymised form? (link to participant broken)  CONTROL Forms.CheckBox.1 \s  In linked anonymised form? (linked to data but participant not identifiable to researchers) If Yes, say who will have access to the code and personal information about the participant:  CONTROL Forms.CheckBox.1 \s  In a form in which the participant could be identifiable to researchers? If Yes, please justify. Who will have control of and act as the custodian for the data generated by the study? Will the research participants receive any payments, reimbursements of expenses or any other benefits or incentives for taking part in this research?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If Yes, please give details.  Will individual researchers receive any personal payment over and above normal salary, or any other benefits or incentives, for taking part in this research? This question is concerned with "in pocket" financial payments or additional benefits to be provided direct to researchers personally, over and above the costs of conducting the research.  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If Yes, please give details.  Section E: Risks and benefits Give details of all procedure(s) or intervention(s) that will be received by participants as part of the research protocol? These include seeking consent, interviews, observations and use of questionnaires. Please complete the columns for each procedure/intervention as follows: Total number of procedures/interventions to be received by each participant as part of protocol. Average time taken per procedure/intervention (minutes, hours or days) Details of who will conduct the procedure/intervention, and where will it take place. Procedure or intervention123 How long do you expect each participant to be in the study in total? Duration of participation should be calculated from when participants give informed consent until their last contact with the research team. What are the potential risks and burdens for research participants and how will you minimise them? For all studies, describe any potential adverse effects, pain, discomfort, distress, intrusion, inconvenience or changes to lifestyle. Only describe risks or burdens that could occur as a result of participation in the research. Say what steps would be taken to minimise risks and burdens as far as possible. Where the research only involves the use of data, consideration should still be given to the risks for participants associated with any breach of confidence or failure to maintain data security.  Will interviews/ questionnaires or group discussions include topics that might be sensitive, embarrassing or upsetting, or is it possible that criminal or other disclosures requiring action could occur during the study?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable If Yes, please give details of procedures in place to deal with these issues:  What is the potential for benefit to research participants? You should state here any potential benefits to be gained by the research participant through taking part in the research either now or in future. However, do not over-emphasise the benefits. In some cases there may be no apparent benefit.  Will the researcher be at risk of sustaining either physical or psychological harm as a result of the research? Please delete as appropriate.  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to the question E6, please give details of potential risks and the precautions which will be taken to protect the researcher.  Section F: Research Involving Human Participants You should only complete this section if you have indicated above that your research will involve human participants. Please indicate the total number of participants you intend to recruit for this study from each participant group: Participant GroupPlease state total numberֱ studentsֱ staffMembers of the public from outside ֱNHS patientsNHS employeesChildren (under 16 years of age)People in custodyPeople with communication or learning difficultiesPeople with mental health issuesPeople engaged in illegal activities (eg. illegal drug use)Other (please specify): * Please declare in Question F8 where the participant group may necessitate the need for standard or enhanced disclosure check How was this participant number decided upon? If a formal sample size calculation was used, indicate how this was done, giving sufficient information to justify and reproduce the calculation. If another method of determining participant numbers was used, please provide sufficient details for the method and justify the decision.  Please state the inclusion and exclusion criteria to be used. (See Research Ethics Guidelines Section 1, paragraph 2.4)  Will you obtain informed consent from or on behalf of research participants?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No Please give details of who will take consent and how it will be done, with details of any steps to provide information (a written information sheet, videos, or interactive material). If you plan to include any participants who are children, please describe the arrangements for seeking informed consent from a person with responsibility and/or from children able to give consent for themselves.  If you are not obtaining consent, please explain why not.  (Children) If you intend to provide children under 16 with information about the research and seek their consent or agreement/assent, please outline how this process will vary according to their age and level of understanding. Copies of written information sheet(s) for parents and children, consent/assent form(s) and any other explanatory material should be enclosed with the application. For further information on providing information and obtaining consent/assent from children, please refer to this online information for best practice:  HYPERLINK "http://www.hra-decisiontools.org.uk/consent/principles-children.html" http://www.hra-decisiontools.org.uk/consent/principles-children.html  Will the research involve participant deception?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s No If you answered Yes to Question F7, please justify the use of deception. Also describe what procedures will be implemented to safeguard the dignity, safety and welfare of the participants during the research and after it has ended. Ethical principles incorporated into the study (please tick as applicable): Ethical principlesWill participants be offered a written explanation of the research?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be offered an oral explanation of the research?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants sign a consent form?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will oral consent be obtained from participants?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be offered the opportunity to decline to take part?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be informed that participation is voluntary?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be offered the opportunity to withdraw at any stage without giving a reason?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will independent expert advice be available if required?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be informed that there may be no benefit to them in taking part?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be guaranteed confidentiality?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be guaranteed anonymity?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will the participant group necessitate a standard or enhanced disclosure check of the researcher?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will the provisions of the Data Protection Act be met?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Has safe data storage been secured?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will the researcher(s) be free to publish the findings of the research?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable If the research involves deception, will procedures be in place during and after the research to safeguard the dignity, safety and welfare of the participants?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable If the research involves questionnaires, will the participants be informed that they may omit items they do not wish to answer?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable If the research involves interviews, will the participants be informed that they do not have to answer questions, and do not have to give an explanation for this?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable Will participants be offered any payment or reward, beyond reimbursement of out-of-pocket expenses?  CONTROL Forms.CheckBox.1 \s  Yes  CONTROL Forms.CheckBox.1 \s  No  CONTROL Forms.CheckBox.1 \s  Not applicable  Section G is a reserved section of the form for applications involving Human Tissues. Please email  HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk if you require a copy of Section G. Section H: Risk Assessment  Reference:  School / Division:Location:DateAssessed by:Job Title:SignatureActivity / Task:Total Number exposed to riskReview Date Ref no.HazardsPeople at riskLikelihoodSeverity Employees and studentsMembers of public/visitorsContractorsYoung peopleMothers: new or expectantImprobableRemotePossibleProbableNo injuryMinorMajorFatalTotal riskExisting control measuresAdequate controls?1.2. FILLIN RefNo \* MERGEFORMAT 3. FILLIN RefNo \* MERGEFORMAT 4.5. Risk value (RV)12341234 FILLIN Notes \* MERGEFORMAT Total risk = Likelihood (RV) x Severity (RV) Total risk of 1 4 = L, low risk Total risk of 6 9 = M, medium risk Total risk of 12 16 = H, high risk  Reference: Remedial action required Ref no.Action requiredTarget dateAction by:Date completed1.    2.    3.    4.    5.     Section I: Declarations by applicant Having completed all the relevant items of this form and, if appropriate, having attached the Information Sheet and Consent Form plus any other relevant documentation as indicated below, complete the statement below. I have read ֱs document on Research Ethics: Regulations, Procedures, and Guidelines. The information in this form is accurate to the best of my knowledge and belief and I take full responsibility for it. In my view this research is: Please tickSee Research Ethics Guidelines Section 6 CONTROL Forms.CheckBox.1 \s Non-invasive CONTROL Forms.CheckBox.1 \s Minor invasive using an established procedure at ֱ CONTROL Forms.CheckBox.1 \s Minor invasive using a NEW procedure at ֱ CONTROL Forms.CheckBox.1 \s Major invasive I understand that research records/data may be subject to inspection by review bodies for audit purposes if required. Access to application for training purposes (please tick as appropriate):  CONTROL Forms.CheckBox.1 \s  I would be content for members of Research Ethics Committees to have access to the information in the application in confidence for training purposes. All personal identifiers and references to sponsors, funders and research units would be removed. Name (if you have an electronic signature please include it here) ________________________________________ Date ____________ If you are a student, show the completed form to your supervisor/Director of Studies and ask them to sign the statement below. If you are a member of staff, sign the statement below yourself. I am the supervisor/Director of Studies for this research. In my view this research is: Please tickSee Research Ethics Guidelines Section 6 CONTROL Forms.CheckBox.1 \s Non-invasive CONTROL Forms.CheckBox.1 \s Minor invasive using an established procedure at ֱ CONTROL Forms.CheckBox.1 \s Minor invasive using a NEW procedure at ֱ CONTROL Forms.CheckBox.1 \s Major invasive I have read this application and I approve it. Name (if you have an electronic signature please include it here) ________________________________________ Date _________________ For all applicants, send the completed form to your Divisional Research Ethics Committee (DivREC) or, if you are an external researcher, submit the completed form to the Secretary to the ֱ Research Ethics Panel ( HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk). You should not proceed with any aspect of your research which involves the use of participants, or the use of data which is not in the public domain, until you have been granted Ethical Approval. For completion by the Divisional Research Ethics Committee (DivREC): Either  CONTROL Forms.CheckBox.1 \s  We refer this application back to the applicant for the following reason(s): Name (if you have an electronic signature please include it here) ______________________________________ (DivREC Member) Date ______________ Please return the form to the applicant. Or Please tick one of the alternatives below:  CONTROL Forms.CheckBox.1 \s  We refer this application to the ֱ Research Ethics Panel.  CONTROL Forms.CheckBox.1 \s  We find this application acceptable and an application for Ethical Approval should now be submitted to a relevant external committee.  CONTROL Forms.CheckBox.1 \s  We grant Ethical Approval for this research. Name (if you have an electronic signature please include it here) _______________________________________ (DivREC member) Date ______________ Please email one copy of this form to the applicant and one copy to the Secretary to the Research Ethics Panel ( HYPERLINK "mailto:ResearchEthics@qmu.ac.uk" ResearchEthics@qmu.ac.uk). Date application returned: ___________________  Protecting Vulnerable Groups This membership scheme was introduced by the Scottish Government to improve disclosure arrangements for people who work with vulnerable groups. When you provide us with the certificate identification number for your PVG status, only authorised countersignatories for this scheme within the university will have access to your PVG records. The Research Ethics Panel and assigned reviewers will not have access or knowledge of your PVG records. Please be aware that if you are barred from working with the research population in your research application, and the PVG countersignatories have been made aware of your application, processes for Fitness to Practice will be triggered within the university.     ֱ Research Ethics application version 3.1.1  PAGE 20  INCLUDEPICTURE "http://intranet.qmu.ac.uk/sites/marketing/ֱC%20Templates/qmulogo_line.jpg" \* MERGEFORMATINET  This text box will expand as required. This text box will expand as required. This text box will expand as required. This text box will expand as required. This text box will expand as required. This text box will expand as required. This text box will expand as required. 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 .@Arialf,HR\B - #@ ( _1689400893@ҋB `1u1uPRINTNOCXDATA,CompObjviiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `  @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox2528153114F 0yCheckBox25Arialࡱ> ObjInfoOCXNAME&contentsTOCXPROPS       !"#$%&()*+,-./012347;=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcefghijklmnopqtxz{|}~Root Entry@ҋB ` b2)XcontentsTCompObjv4F 0GCheckBox2a5Arial @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19q #  _1689400892@ҋB `1u1uPRINT'NOCXDATA5,CompObj6v- !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `  @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qObjInfo8OCXNAME9&contents:TOCXPROPS< CheckBox2528153124F 0.CheckBox25Arialࡱ> Root Entry@ҋB `0nb2)XcontentsTCompObjv4F 0GCheckBox2a5Arial @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19q #  - !- !  .@ArialfHR\B - #@ _1689400891@ҋB `1u1uPRINTdNOCXDATAr,CompObjsv ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `  @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox2528153134F 0.CheckBox25ObjInfouOCXNAMEv&contentswTOCXPROPSy Arialࡱ>      % !$"#&+9'()*,.-/501234687:?T;<=>@BACFDEHGJIKNLMPORQSWUqVYX[Z\_]^a`cbdgefihkjlomnrptsuxvwzy|{}~Root Entry@ҋB ``b2)XcontentsTCompObjv4F 0GCheckBox2a5Arial @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19q #  - !- ! 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T_1689400883@ҋB ` Xu XuPRINT# NCheckBox252815114F 0.CheckBox25Arial #  - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815214F 0.CheckBox25Arial #  CompObj1 vObjInfo3 OCXNAME4 $contents5 T_16894008824@ҋB ` Xu XuPRINT7 NCompObjE vObjInfoG - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME H $contentsI T_1689400881 @ҋB ` Xu XuPRINTK NCheckBox252815314F 0~CheckBox2c5Arial #  - !- !  .@Arialf{HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281544F 0.CheckBox2'5Arial #  CompObj Y vObjInfo[ OCXNAME \ "contents] T_1689400880 @ҋB ` Xu XuPRINT_ NCompObjm vObjInfoo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEp "contentsq T_1689400879@ҋB ` Xu XuPRINTs NCheckBox25291514F 0.CheckBox2(5Arial #  - !- !  .@ArialfHR\B - #@ (  iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281554F 0CheckBox25Arial #  CompObj vObjInfo OCXNAME "contents T_1689400878(@ҋB ` Xu XuPRINT NCompObj  vObjInfo - !- !  .@Arialf.HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME! "contents T_1689400877$@ҋB `0u0uPRINT NCheckBox25291524F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox2528154114F 0CheckBox25Arial #  CompObj#& vObjInfo OCXNAME%' &contents T_1689400876."*@ҋB `0u0uPRINT NCompObj), vObjInfo - !- !  .@Arialf6HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME+- &contents T_16894008750@ҋB `0u0uPRINT NCheckBox2528154124F 0CheckBox2c5Arial #  - !- !  .@Arialf7HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox2528154134F 0.CheckBox2(5Arial #  CompObj/2 vObjInfo OCXNAME13 &contents T_1689400874L6@ҋB `0u0uPRINT NCompObj58 vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME79 $contents T_1689400873<@ҋB `0u0uPRINT NCheckBox252815414F 0.CheckBox2c5Arial #  - !- !  .@Arialf<HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252915114F 0CheckBox2(5Arial #  CompObj;> vObjInfo OCXNAME=? $contents T_1689400872F:B@ҋB `0u0uPRINT NCompObjAD vObjInfo                       " & ( ) * + , - . / 0 1 2 3 4 6 : < = > ? @ A B C D E F G H J N P Q R S T U V W X Y Z [ \ ^ b d e f g h i j k l m n o p r v x y z { | } ~  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMECE $contents T_1689400871H@ҋB `0u0uPRINT NCheckBox252815424F 0.CheckBox2'5Arial #  - !- !  .@ArialfBHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252915124F 0CheckBox25Arial #  CompObjGJ! vObjInfo# OCXNAMEIK$ $contents% T_1689400870X@N@ҋB `0u0uPRINT' NCompObjMP5 vObjInfo7 - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEOQ8 &contents9 T_1689400869T@ҋB `@u@uPRINT; NCheckBox2528154214F 0CheckBox2c5Arial #  - !- !  .@Arialf+HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox2529151214F 0CheckBox2(5Arial #  CompObjSVI vObjInfoK OCXNAMEUWL &contentsM T_1689400868^RZ@ҋB `@u@uPRINTO NCompObjY\] vObjInfo_ - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME[]` (contentsa T_1689400867`@ҋB `@u@uPRINTc NCheckBox25281541114F 0CheckBox25Arial #  - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541214F 0CheckBox25Arial #  CompObj_bq vObjInfos OCXNAMEact (contentsu T_1689400866$f@ҋB `@u@uPRINTw NCompObjeh vObjInfo  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEgi (contents T_1689400865l@ҋB `@u@uPRINT NCheckBox25281541314F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541124F 0CheckBox25Arial #  CompObjkn vObjInfo OCXNAMEmo (contents T_1689400864vjr@ҋB `@u@uPRINT NCompObjqt vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEsu (contents T_1689400863x@ҋB `@u@uPRINT NCheckBox25281541224F 0.CheckBox2c5Arial #  - !- !  .@Arialf7HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541324F 0.CheckBox25Arial #  CompObjwz vObjInfo OCXNAMEy{ (contents T_1689400862p~@ҋB `@u@uPRINT NCompObj} vObjInfo - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400861@ҋB `@u@uPRINT NCheckBox25281541134F 0CheckBox25Arial #  - !- !  .@ArialfoHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541234F 0CheckBox25Arial #  CompObj vObjInfo OCXNAME (contents T_1689400860@ҋB `@u@uPRINT NCompObj vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400859@ҋB `@u@uPRINT N                   ! " # $ & * , - . / 0 1 2 3 4 5 6 7 8 : > @ A B C D E F G H I J K L N R T U V W X Y Z [ \ ] ^ _ ` b f h i j k l m n o p q r s t v z | } ~  CheckBox25281541334F 0CheckBox25Arial #  - !- !  .@Arialf)HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541144F 0.CheckBox2c5Arial #  CompObj vObjInfo OCXNAME (contents T_1689400858|@ҋB `PuPuPRINT NCompObj% vObjInfo' - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME( (contents) T_1689400857@ҋB `PuPuPRINT+ NCheckBox25281541244F 0.CheckBox25Arial #  - !- !  .@Arialf&HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541344F 0CheckBox25Arial #  CompObj9 vObjInfo; OCXNAME< (contents= T_1689400856@ҋB `PuPuPRINT? 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'(a|$Pki6x1Ixk.&[HM{5G+BLDd b  c $A? ?3"`?g2L MOo(^`!  MOoFH.H.xcdd``^Ġ $XHs3D@,&~~f KH ˦.j6F& - #)Ŀ>, `Y&Ǣ49Π 8 sC\6/8΀220 Ō `9z0NG `X`cBhH]ff&#>d 0qy(@JWrqLBDd b  c $A? ?3"`?h2LJԺ,3(``! JԺ,3FH.H.xcdd``^Ġ $XHs3D@,&~~f KH ˦.j6F& - #)Ŀ>, `Y&Ǣ4UΠ 8 sC\6/8΀220 Ō `9z0NG `X`cBhH]ff&#>d- !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEP (contentsQ T_1689400855@ҋB `PuPuPRINTS NCheckBox25281541154F 0.CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541254F 0g_CheckBox2c5Arial #  CompObja vObjInfoc OCXNAMEd (contentse T_1689400854@ҋB `PuPuPRINTg NCompObju vObjInfow - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEx (contentsy T_1689400853@ҋB `PuPuPRINT{ N     8 "!#&$%('*)+.,-0/21364597;Q:<?=>A@CBDGEFIHKJLOMNRPTmSUXVWZY\[]`^_badcehfgjilknqopsrutvywx{z}|~CheckBox25281541354F 0CheckBox2(5Arial #  - !- !  .@ArialfHR\B - #@ (  iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541164F 0CheckBox2c5Arial #  CompObj vObjInfo OCXNAME (contents T_1689400852@ҋB `PuPuPRINT NCompObj vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400851@ҋB `PuPuPRINT NCheckBox25281541264F 0.CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541364F 0CheckBox25Arial #  CompObj vObjInfo OCXNAME (contents T_1689400850@ҋB `PuPuPRINT NCompObj vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400849@ҋB `PuPuPRINT NCheckBox25281541174F 0CheckBox2*5Arial #  - !- !  .@Arialf=HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541274F 0CheckBox2(5Arial #  CompObj vObjInfo OCXNAME (contents T_1689400848@ҋB `PuPuPRINT NCompObj vObjInfo - !- !  .@ArialfNHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400847@ҋB ``u`uPRINT NCheckBox25281541374F 0CheckBox25Arial #  - !- !  .@ArialfMHR\B - #@ (                 ! " # $ % & ' ( * . 0 1 2 3 4 5 6 7 8 9 : ; < > B D E F G H I J K L M N O P R V X Y Z [ \ ] ^ _ ` a b c d f j l m n o p q r s t u v w x z ~ iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541184F 0CheckBox25Arial #  CompObj vObjInfo OCXNAME (contents T_1689400846@ҋB ``u`uPRINT NCompObj vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME (contents T_1689400845@ҋB ``u`uPRINT NCheckBox25281541284F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541384F 0.CheckBox25Arial #  CompObj) vObjInfo+ OCXNAME, (contents- T_1689400844@ҋB ``u`uPRINT/ NCompObj= vObjInfo? - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME@ (contentsA T_1689400843@ҋB ``u`uPRINTC NCheckBox25281541194F 0.CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox25281541294F 0.CheckBox25Arial #  CompObjQ vObjInfoS OCXNAMET (contentsU T_1689400842 @ҋB ``u`uPRINTW NCompObje vObjInfog - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEh (contentsi T_1689400841@ҋB ``u`uPRINTk NCheckBox25281541394F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815411104F 0CheckBox25Arial #  CompObjy vObjInfo{ OCXNAME| *contents} T_1689400840@ҋB ``u`uPRINT NCompObj vObjInfo  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME *contents T_1689400839@ҋB ``u`uPRINT NCheckBox252815412104F 0eCheckBox2c5Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815413104F 0LCheckBox2!5Arial #  CompObj  vObjInfo OCXNAME   *contents T_1689400838@ҋB ``u`uPRINT NCompObj  vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME *contents T_1689400837@ҋB ``u`uPRINT NCheckBox252815411114F 0^_CheckBox2'5Arial #  - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815412114F 0CheckBox25Arial #  CompObj vObjInfo OCXNAME *contents T_1689400836@ҋB `pupuPRINT NCompObj vObjInfo - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME *contents T_1689400835 @ҋB `pupuPRINT NCheckBox252815413114F 0CheckBox25Arial #  - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815411124F 0.CheckBox25Arial #  CompObj" vObjInfo OCXNAME!# *contents T_1689400834&@ҋB `pupuPRINT NCompObj%( vObjInfo                   ! " # $ % & ' ( ) * + , . 2 4 5 6 7 8 9 : ; < = > ? @ B F H I J K L M N O P Q R S T V Z \ ] ^ _ ` a b c d e f g h j n p q r s t u v w x y z { | ~ - !- !  .@Arialf@HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME') *contents T_1689400833,@ҋB `pupuPRINT NCheckBox252815412124F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815413124F 0CheckBox2c5Arial #  CompObj+. vObjInfo OCXNAME-/ *contents T_16894008326*2@ҋB `pupuPRINT NCompObj14- vObjInfo/ - !- !  .@Arialf~HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME350 *contents1 T_16894008318@ҋB `pupuPRINT3 NCheckBox252815411134F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815412134F 0CheckBox25Arial #  CompObj7:A vObjInfoC OCXNAME9;D *contentsE T_1689400830H0>@ҋB `pupuPRINTG NCompObj=@U vObjInfoW - !- !  .@Arialf9HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME?AX *contentsY T_1689400829D@ҋB `pupuPRINT[ NCheckBox252815413134F 0sCheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815411144F 0.CheckBox2c5Arial #  CompObjCFi vObjInfok OCXNAMEEGl *contentsm T_1689400828NBJ@ҋB `pupuPRINTo NCompObjIL} vObjInfo - !- !  .@ArialfFHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEKM *contents T_1689400827P@ҋB `pupuPRINT N CheckBox252815412144F 0cCheckBox2(5Arial #  - !- !  .@ArialfKHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815413144F 0CheckBox25Arial #  CompObjOR vObjInfo OCXNAMEQS *contents T_1689400826l<V@ҋB `puBuPRINT NCompObjUX vObjInfo - !- !  .@ArialfQHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEWY *contents T_1689400825\@ҋB `BuBuPRINT NCheckBox252815411154F 0wCheckBox25Arial #  - !- !  .@Arialf:HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815412154F 0sCheckBox25Arial #  CompObj[^ vObjInfo OCXNAME]_ *contents T_1689400824fZb@ҋB `BuBuPRINT NCompObjad vObjInfo - !- !  .@Arialf/HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEce *contents T_1689400823h@ҋB `BuBuPRINT NCheckBox252815413154F 0CheckBox2(5Arial #  - !- !  .@ArialfHR\B - #@ ( usiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815411164F 0cCheckBox2c5Arial #  CompObjgj vObjInfo OCXNAMEik *contents T_1689400822x`n@ҋB `BuBuPRINT NCompObjmp vObjInfo - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEoq *contents T_1689400821t@ҋB `BuBuPRINT NCheckBox252815412164F 0CheckBox25Arial #  - !- !  .@ArialfKHR\B - #@ (  "$%&'()*+,-./02689:;<=>?@ABCDFJLMNOPQRSTUVWXZ^`abcdefghijklnrtuvwxyz{|}~iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815413164F 0CheckBox25Arial #  CompObjsv vObjInfo OCXNAMEuw *contents T_1689400820~rz@ҋB `BuBuPRINTNCompObjy|vObjInfo- !- !  .@Arialf-HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME{} *contents!T_1689400819@ҋB `BuBuPRINT#NCheckBox252815411174F 0CheckBox25Arial #  - !- !  .@Arialf!HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815412174F 0ͷCheckBox25Arial #  CompObj1vObjInfo3OCXNAME4*contents5T_1689400818T@ҋB `BuBuPRINT7NCompObjEvObjInfoG- !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEH*contentsIT_1689400817@ҋB `BuBuPRINTKNCheckBox252815413174F 0CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815411184F 0cCheckBox25Arial #  CompObjYvObjInfo[OCXNAME\*contents]T_1689400816@ҋB `BuBuPRINT_NCompObjmvObjInfoo- !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAMEp*contentsqT_1689400815@ҋB `iuiuPRINTsNCheckBox252815412184F 0.CheckBox25Arial #  - !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815413184F 0CheckBox25Arial #  CompObjvObjInfoOCXNAME*contentsT_1689400814@ҋB `iuiuPRINTNCompObjvObjInfo- !- !  .@ArialfHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME*contentsT_1689400813@ҋB `iuiuPRINTNCheckBox252815411194F 0CheckBox25Arial #  - !- !  .@Arialf HR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qCheckBox252815412194F 0CheckBox25Arial #  CompObjvObjInfoOCXNAME*contentsT_1689400812@ҋB `iuiuPRINTNCompObjvObjInfo- !- !  .@ArialfDHR\B - #@ ( iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii' @ҋB `Microsoft Forms 2.0 CheckBoxEmbedded ObjectForms.CheckBox.19qOCXNAME*contentsT_1689400811@ҋB `uuPRINTNCheckBox252815413194F 0CheckBox2'5Arial #  - !- !  .@ArialfUHR\B - #@ (  0qy(@JWrIx$$If!vh#vj$:V l t0j$65j$yt0cDd b  c $A? ?3"`?i2LƽllY9[)#0'(`! ƽllY9[)#0'FH.H.xcdd``^Ġ $XHs3D@,&~~f KH ˦.j6F& - #)Ŀ>, `Y&Ǣ4IΠ 8 sC\6/8΀220 Ō `9z0NG `X`cBhH]ff&#>d 0qy(@JWrd=Dd b  c $A1? ?3"`?j2K"*JUl ?'`!"*JUl ?FH.H.xS1n@=8.h("J PQS Y|'X+:H́qHDXlC D8x;E.G~όLIгcʲ R]QW$)rMsEGr:}W=^pI\2Dd b  c $A<? ?3"`?k2L?ag"(`! 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