Education Research And Evaluation Scholar Award

Pennsylvania Department of Education Research Scholars Application

Applicant Name:

Institution:

Department:

Program of Study:

Address:

City: Zip Code:

Telephone #: Email Address:

Faculty Mentor, if applicable:

Title:

Address:

City: Zip Code:

Telephone #: Email Address:

Training: Applicants who will have contact with human subjects and/or access to identifiable personal records must complete training in human subject protections. A certificate of completion should be attached to each Curriculum Vitae (CV). HIPAA, Good Clinical Practice, or Responsible Conduct of Research training is not accepted in lieu of human subjects protections training.

Name of Most Recent Human Subjects Protection Training Date Completed:

Please list the relevant priorities related to the PDE Research Agenda Topics and Questions that will be addressed:

Data Requested: Please provide a description of the requested data to be used to answer the questions listed in prior application question #1. If access to unit record level data is necessary to accomplish the goals of this project, please explain why.

Project Abstract: The abstract should summarize the project description, including rationale, methods, proposed analyses, and implications.

Introduction: Address the activity for which funds are being requested. Provide the nature and scope of the priority being addressed, clearly and concisely state the research questions and related hypotheses, discuss how the proposed research or analyses will contribute to further understanding. Please identify any unique aspects of the project.

Methods: Detail your plan of action for how the proposed project will accomplish the goals and objectives related to the research questions and priorities of interest. Methods should include proposed sample, measures, and procedures.

Proposed Data Analysis: Detail the analysis that will be used to address stated research questions. Discuss the criteria that will be used to evaluate and interpret the results.

Implications: Please discuss the implications of findings from the proposed research and how PDE can use the research in its final form. What implications will the findings have for future program and policy decisions, including anticipated benefits of the study and potential for improving instructional and educational outcomes?

Anticipated Benefits: Please describe any anticipated benefits for individual subjects or class of subjects whose records are being used in this research or analysis and/or how it will contribute to general knowledge.

Project Management Timeline: Please indicate when research or analysis activities will be completed.

Budget Narrative: Please provide a narrative budget justification for the proposed project. The narrative budget justification should describe how the categorical costs are derived. Discuss the necessity, reasonableness, and allocation of the proposed costs.

If this application is approved, you will be required to submit an IRB for review and approval for your study through PDE.

Are you obligated to use your institutions IRB for this project? YES NO

Has another IRB reviewed and approved this project? YES NO

Has another IRB declined to review, tabled, deferred, disapproved, suspended, or terminated this study? If yes, please provide a brief explanation:

Is this research funded by a grant, contract, cooperative agreement, or other award?

Type of Funding Sources:

Federal State/Local Government Private Foundation

Other - Explain

Funding Agencies Name:

Research Budget Total:

Start Date: End Date:

By signing this Application I verify, subject to the penalties of Section 4904 of the Crimes Code (18 Pa.C.S. 4904) relating to unsworn falsification to authorities, that the facts set forth in this application or submitted electronically as a component of this application are true and correct.

Applicant:

Title: Date:

Faculty Mentor Signature, if applicable:

Date: