Sample authorization Letter Template


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NameSample authorization Letter Template
A typeDocumentation
SAMPLE Authorization Letter Template
[Organization LETTERHEAD]

October 26, 2012
Institutional Review Board

c/o: Research & Sponsored Programs Office

CSU Channel Islands

One University Drive – Madera Hall 1300

Camarillo, CA 93012

Dear IRB Members,
After reviewing the proposed study, “[project title]”, presented by [name of researcher], [title and department affiliation] at California State University Channel Islands, I am granting permission for the study to be conducted at [school site].
I understand the purpose of the project is to determine [insert purpose of research]. The primary activity at [Name of School] will be [list all research activities to be conducted at the site]. The following students are eligible to participate: [describe participants i.e. grade, class].
I understand that [provide a brief description of activities] will occur for [time and instructions: e.g.: three weeks during normal classroom instruction, and during students’ regularly scheduled spelling instruction. This is a daily event, with lessons lasting from 20 to 25 minutes.] I expect that this project will end not later than [provide an end date].
I understand that [name of researcher] will obtain consent for all [Name of School] students participating in the study. [Name of researcher] has agreed to provide to my office a copy of all CSU Channel Islands approved study protocol materials including the approved consent documents before [s/he] recruits participants on campus. Any data collected by [name of researcher] will be kept confidential and will be stored in a secure location per the approved protocol. [name of researcher] has also agreed to provide to us a copy of the aggregate results of the research.
If the CSU Channel Islands Institutional Review Board has any concerns about the permission being granted by this letter, please contact me at the [phone number &/or email address] listed below.

Sincerely,

[signature if submission is original] [name and title of ranking authority as appropriate] [name of organization] [direct phone &/or email]

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