Acap Human Research Application Cover Sheet
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1Human Research Application
Cover Sheet
Instructions for preparing your Human Research Application for Submission to the Head of School for
authorisation for Ethical Review by the ACAP HREC
Complete all applicable sections of this cover sheet.
1.
Attach your completed cover sheet to your completed NEAF Application form and Research Proposal,
2.
number all pages of your submission making this cover sheet page 1, and submit your compiled Human Research
Application to your research supervisor for their review and approval for your forwarding to the Head of School for
authorisation and submission to the ACAP HREC Secretary. Before forwarding your supervisor approved Human
Research Application to the Head of School, make a copy for your own research records. (PDF scan recommended).
Send your supervisor approved, complete Human Research Application submission (in hard copy format or electronic
3.
format) to the Head of School of Counselling or Head of School of Psychological Sciences (as applicable) ACAP, Locked
Bag 11, Strawberry Hills NSW 2012. Ph: (02) 99646375 Email:
hrecsecretary@acap.edu.au
Applicant Details
Applicant name
Applicant daytime contact number
Students to complete the following
Student Number
Course
Unit in which undertaking project
Term in which undertaking project
Study Mode (i.e. Flexible delivery/on-campus)
Campus (if studying on-campus)
Staff/Research Partners to complete the following
Organisational Position
School/ Department
Human Research Project Details
Title of project
Principal research supervisor name
Principal research supervisor email
Secondary research supervisor name
(if applicable)
Secondary research supervisor email
(if applicable)
This is page 1 of ____ pages in this application submission
Applicant Signature _________________________________________
Date ______________________
Approvals
Research Supervisor Approval
As Research Supervisor, I have reviewed this Human Research Application and approve it for submission by the
applicant to the Head of School for consideration for approval and submission to the ACAP HREC for ethical review.
(Note: If signing supervisor is a casual employee of ACAP, a second approval MUST also be obtained from an
authorised permanent ACAP academic staff member).
Signature _____________________________________________________
Date ________________________
Secondary approval by permanent authorised ACAP academic staff member – if applicable
Signature _____________________________________________________
Date ________________________
Head of School authorisation for forwarding to ACAP HREC for Ethical Review
Signature _____________________________________________________
Date ________________________
Page 1 of 1
[NHMRC ACAP HREC Registration Identification Numbers: HREC: EC00447
Organisation: ORG0576]
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