邢唷��>� ;=��:��欹�a ��{!bjbjj趈� 4"�?b�?bE ��ff��$��.^��ggg,......$��pR9�(gg((R��XXX(��,X(,XXX��劳睖懼��>^X�0�X��X��X�gZ�@X45�gggRR*.ggg�((((��gggggggggfB�: OCCIDENTAL COLLEGE CONSENT FORM TO CONDUCT RESEARCH ON SITE Faculty Supervisor/Principal Investigator: FORMTEXT Student Investigator(s)/Research Assistant(s): FORMTEXT Title of research project: FORMTEXT I acknowledge that on FORMTEXT , I was informed by FORMTEXT of Occidental College about this research project, the way it will be conducted and the conditions of participation in it . I have received copies of the appropriate documents checked below which provide the essential descriptions of the proposed project: ___ Informed Consent Form for Minor Child ___ Informed Consent Form for Adult Subjects ___ Parental Information Letter ___ Data Archival Consent Form ___ Informed Consent Form for Film Projects ___ Aforementioned documents in the appropriate and Documentaries/Subject Release Form language (if other than English) This institution is fully aware of the nature and extent of the subject抯 participation in this project and agree with full knowledge of all details to allow the subjects to participate. Subjects may withdraw their participation on this project at any time without prejudice or penalty of any kind. In the case of minors, parents/guardians will be informed that they may withdraw their child抯 participation on this project at any time without prejudice or penalty of any kind. On behalf of the institution, I give my consent for the research investigator(s) to utilize this site to recruit and interview its members/students. Permission to conduct research is granted beginning (date) ___________________ and ending (date) ___________________. Name (print): ________________________________________ Date: ____________________ Signature: ____________________________________________________________________ Title: ________________________________________________________________________ $&x~�� & � � � � � � � � � � � � � 菸篙澼嗶倊鼁菸d轁輅U鼁菸hVR�h�5�B*ph�hVR�+�jth�)hYt#CJOJQJUaJhYt#h丠sh [e-jhYt#OJPJQJU^JmHnHo(u5jhYt#CJOJPJQJU^JaJmHnHo(u+�jh�)hYt#CJOJQJUaJh�)hYt#CJOJQJaJ%jh�)hYt#CJOJQJUaJh h�1�h��h�5�&x€( � ��ef�� a � � � ��Z[��'��gd{Oa勑`勑gd98�gd�5�$a$gd�5� . J L N P d f h r t � � � � � � � � � � � � �ef�橹恢烦譅娭恢穯爌只謑穐d穈UhBt�hBt�CJaJhBt�h韝h祕�h鏞@+�j�h�)hYt#CJOJQJUaJhYt#+�j\h�)hYt#CJOJQJUaJh�)hYt#CJOJQJaJh峫h瀙�h�5�5jhYt#CJOJPJQJU^JaJmHnHo(u%jh�)hYt#CJOJQJUaJ+�j�h�)hYt#CJOJQJUaJ�� / ` i p � � � � � � � � � � � � � �� #BD辛敌弸噧噵�tltd嘸噵嘰h�8-h丠sh�B*ph�h騬HB*phh丠sh�B*phh�Qh,X9h縋�hCN<�h{Oah{OaCJaJh{OaCJaJh�5�hBt�hBt�hBt�CJaJh�-B*CJaJph�h丠sh�-B*CJaJphh��CJaJh98�CJaJhk�CJaJh絳�CJaJh鏞@CJaJhBt�CJaJ$DEFV��&(wx� � � � [!z!{!腌茜茜卦稍卦嘏嘏门耘炕�h�5�h*xh� 8Uh[8hm0<�hm0<�CJaJhm0<�h,X9h縋�h縋�CJaJh縋�h丠shCN<�hCN<�hCN<�hCN<�h縋�'(xy��S T � � � � � {!��gd�5� Name of the institution: _________________________________________________________ Address: _____________________________________________________________________ Phone number: ______________________ Email: ___________________________________ The institution抯 representative should sign two copies of this form. Keep one copy and return the other copy to the investigator. 21恏:p 靶/ 班=!盃"盃#悁$悁%�靶靶愋tD��Text1tD��Text1tD��Text1tD��Text1tD��Text1�s2��&6FVfv��2(��&6FVfv��&6FVfv��&6FVfv��&6FVfv��&6FVfv��&6FVfv��8X�V~��€�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@_HmH nH sH tH @`�@NormalCJ_HaJmH sH tH DA ��DDefault Paragraph FontRi��RTable Normal�4� l4�a�(k ��(No ListH��H鏞@Balloon TextCJOJQJ^JaJPK!檗�[Content_Types].xml瑧薔�0E鱄鼉�-J湶@%閭菐洽|廊�$韶钵UL襎B� l,�3鳛;鉹�得槣B+$�G]ミ7O侪V墎�c:菜�E3v@釶莮�憇� |煓w�<�<爔k猴ll5� 玈Z埣2O,辜帣Q績� €‰壪�5y�;y=卐E颎翼帊|\P疼鞭M7�$|n]�枌蓢]4忥`窾6涀G冼(垲�^斗菹颻琖��-翻関]m蓿瓄�  飍祡缧暺}攙旯缦r�鍧竔倲崜0�� D3劂梋閐�3譙钐嚟�耳杧:忲�8}d-楀鉯*壵x上轻qCよZ}�柣WlшqyI@赹剟6橧!Q_� ﹪s殔刏賩a汛癶H魉Tm�jyV`垆纅�榾惫�<箣犇鼁YpL8�*аx侏S&机;EUC�8⒊eE�<В悟hg贇!燴H睩x0� VM螽憆刳u�6拺覦s�3 U慮赢b��6�怂5y嵳2臓iz嘜]r汯璠�'鋆炃弦u涎4jj採�K臀F娃盶�晕�$4寨-莓�-�珠`餜�熘��&藑代觥瀈A<吼"xNW﹦� � 袬鞩R賭[鋺萵 8r� i箯K~�*~P(5黕莲z胦Wm忒杮~乖鞹濦caT鲇�.}x E僮5抉&Z緄�2bQ懇/,EE\}�)W�乹埼鉠ミ�6;礏弛�糿h礜贻~7�威�9R`痌糧疩〞儬嗾J拁▄旿郢�=$燮朗Sb酻紇��PK! 褠煻'theme/theme/_rels/themeManager.xml.rels剰M �0匃倃oo雍�&輬协�勪5 6?$Q祉 �,.嘺緳i粭澤c2�1h�:闀q毩m胳嶡RN壻;d癭値o7�g慘(M&$R(.1榬'J摐袏T鶂�8V�"＆A然蠬鱱}狇�|�$絙{�朠�除8塯/]As賲(⑵锑#洩L蔥汉倪��PK-!檗�[Content_Types].xmlPK-!ブх�60_rels/.relsPK-!ky��theme/theme/themeManager.xmlPK-!稝��theme/theme/theme1.xmlPK-! 褠煻'� theme/theme/_rels/themeManager.xml.relsPK]� E "�� D{! '{! kw}�� '39NZ`E F�晞F�晞F�晞F�晞F�晞�8�@��€€€�饞��0�( � �養 �S�� ?��(}!)}!*}!+}!,}!-}!eepG owwG =*€urn:schemas-microsoft-com:office:smarttags €PlaceType€=*€urn:schemas-microsoft-com:office:smarttags €PlaceName€9*€urn:schemas-microsoft-com:office:smarttags€place€��G #'5Cqt6Fz� ��G 3333333%%''::<<MMaa��DDG ��DDG *�)峫[8鱥韝�-Yt#�8-D.2� 8,X9m0<�CN<�鏞@IH騬H�Q�\�2^{Oa [e丠s*x�-�VR��-�k�Bt�縋�D7�乥�絳�瀙�98��1��&��5�祕�E G �@€��4�E �� @�@@��Unknown��G��.郲x� �Times New Roman5�€Symbol3.��.郲x� �Arial7.��燵 @�VerdanaK=�€ �帑j�MS Gothic-�3� 񾷼򬿴U�€ MS MinchoYu Gothic UI5.��.醄`�)�TahomaA��$B�Cambria Math"��鹦h鲍�'硥Gb�b�a��€��亖24A A 3僎�HP �?��5�2!xx� 莤��OCCIDENTAL COLLEGEmolikWindows User� 鄥燆鵒h珣+'迟0�� @L Xdlt|�OCCIDENTAL COLLEGEmolikNormal.dotmWindows User4Microsoft Office Word@襂k@顝a愔@L締懼b�� 胀諟.摋+,0hp�� bet365 withdraw ITSA OCCIDENTAL COLLEGETitle �� !"#$%&'()��+,-./01��3456789��<��Root Entry�� F@璺�懼>€Data ��1Table��WordDocument��4"SummaryInformation(��*DocumentSummaryInformation8��2CompObj��r�� F Microsoft Word 97-2003 Document MSWordDocWord.Document.8�9瞦