Please clearly and succinctly complete each question. Applications with incomplete answers will be returned to the requester prior to review by the Committee on Research (COR). The committee meets once each month, generally on the 3rd Wednesday. Please allow at least 2 weeks following the COR meeting to receive a written response.

Requester's Name


Proposed Title of Research


Estimated Completion Date of Research


Your Current Affiliation with UOPX


Requester's Primary Employer


Requester's Job Title


Primary Purpose of Research


Dissertation Information

Other Information

Under Whose Primary Sponsorship is the Research Being Done?


What is the Name of the Primary Sponsor Selected Above?


Requester's Contact Information

Phone Number


Email Address


Mailing Address Line 1


Mailing Address Line 2








Please include your vita with this form by using the "ATTACH" button at the bottom of this form.

Research Details

Statement of Research Question




Review of Literature



Method of Data Collection


Method of Data Analysis


Data Logistics



Expected Contribution


Results Used by Researcher


Results Used by UOPX


Informed Consent and Confidentiality

Researcher Acknowledgments

All Research that will involve working with human subjects or data related to human subjects must also be reviewed by the University's Institutional Review Board (IRB). The Federal Policy for the Protection of Human Subjects (45 CFR 690) can be accessed at

If your research is approved by COR and will involve human subjects or data related to human subjects, you will be required to complete the "University of Phoenix Institutional Review Board Application to Conduct Research Using Human Subjects" form. You may request this form by contacting Upon completion of the form, you must send it to the University of Phoenix Institutional Review Board as noted on the form.

Researcher acknowledges having read the Federal Policy for the Protection of Human Subjects.
If applicable, researcher acknowledges that no human subjects or data relating to human subjects will be involved in this research by checking below.
Researcher acknowledges that no federal or state laws will be violated while conducting the research and that research may not be conducted where the disclosure of responses outside the research project could reasonably place the subjects at risk of criminal or civil liability or be damaging to the subject's financial standing, employability, or reputation.
Reminder: Please ensure this application is filled out completely and includes your vita. Incomplete packages will not be forwarded to the Committee on Research for review.
Add attachments by clicking here -->ATTACH

 ‭(Hidden)‬ Temp Fix for HHS Link