Application Form for

Permission to Conduct
Research
in Tasmanian Government Educational Settings

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Strategy and Performance
Department of Education
 TITLE OF RESEARCH PROJECT

See http://www.education.tas.gov.au/Community-and-Providers/initiatives/Pages/Research-in-Government-Schools.aspx
for Guidelines for Conducting Research in Tasmanian Government educational settings.

INFORMATION ABOUT THE APPLICANT/S

1. Name/s of Supervisor/s

Position/Present appointment
Postal Address
Telephone Number
Email address

2. Academic qualifications of
Supervisor/s

3. Name of Applicant/s

Position/Present appointment
Postal Address
Telephone number/s
Email address

4. Is this study contributing towards

an academic qualification? (please
specify)

5. Date and Reference Number of the

approval from the relevant Ethics
Committee(s) or sponsoring &/or
administering institution(s)

6. Are you a registered teacher in Yes TRB Number ____________________________Expiry _____________

Tasmania?
No

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 INFORMATION ABOUT THE RESEARCH PROJECT

7. Organisation or institution through

which the research is to be
conducted (if any)

8. If there is a financial grant for this

study, indicate the provider and the
amount of funding received

9. Aims of the study, including

educational significance

10. What benefits to students will the

study provide?

11. What benefits to educational

settings and teachers will the study
provide?

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Page 4 of 14
12. Outline of proposed research plan

(a). Preliminary investigations or pilot

studies if intended

(b). General outline of research

methods to be used for collecting
information

(c). Schedule of activities, including

time-line for completion of entire
program

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Page 6 of 14
13. Names and number of selected
educational settings

If not school/college based indicate

other DoE locations required

or

method of delivery eg online; phone

14. Subjects/students required

(a). Indicate year levels (or ages) and

the approximate number of
students required per location at
each year (or age) level

State any other necessary

characteristics of students

(b). Indicate whether subjects/students

will be required individually or in
groups. If in groups, give size

(c). Give approximate dates and

amount of time required

(d). Are any adults required as subjects Yes No

for this research?

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Page 8 of 14
15. If teachers are required to assist
the researcher, describe what they
will be asked to do and the
amount of time required

(Attach copies of instructions to be

given to teachers)

16. Where active consent is sought

from students and/or
parents/carers, how is it to be
obtained?

(Refer to Guidelines on “Informed

Consent”)

(Attach copies of materials used to

inform parents/carers and/or students,
and relevant consent forms)

17. Instruments and other forms of

data collection

Where these are well known and

commonly used (e.g. those listed in the
ACER Catalogue) list the name(s) of
the instruments

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Otherwise enclose a copy of each
instrument and its accompanying
covering letter and instructions

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For all instruments you intend using,
clearly indicate the group to whom it is
to be administered (e.g. parents,
teachers, students)

Describe how each is to be

administered and give an estimate of
the time required

18. Will you require access to data

already residing with the Yes No
Department of Education? (if yes, refer to Guidelines)

19. Outline your plans for

disseminating the results of these
investigations

20. Expected date of dissemination

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Page 12 of 14
 DECLARATION
I/we agree to abide by the conditions set out in the Guidelines for Conducting Research in Tasmanian
Government educational settings

I/we, the undersigned declare that the information supplied is true and accurate to the best of
my/our knowledge.

I/we understand that upon completion of the above research, a report is to be submitted to the
Department of Education and feedback is to be provided to the participating educational settings.

Signature of Supervisor/s: ---------------------------------------------------------

Signature of Applicant/s: ---------------------------------------------------------

Date: ---------------------------------------------------------

Checklist (Please complete)

 Relevant Research and Ethics Committee Approval has been received from the
sponsoring/administering organisation and evidence of approval is attached.

 Scanned copy of each researcher’s Tasmanian Working with Vulnerable People Card.

 Copies of the proposed letter to principal, consent forms, plain language statements and
instruments etc, are attached (as applicable).

 The Declaration has been signed and dated by all investigators.

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Signed application, together with attachments, should be forwarded to:

Research Applications

Education Performance and Review

DEPARTMENT OF EDUCATION

GPO Box 169

HOBART TAS 7001

Or email to

epr@education.tas.gov.au

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