MAT Educational Research Exemption Determination Form
MAT research may qualify for exempt status, meaning that it does not require full IRB review. To
have your research considered for exempt status, please complete the following form.
1. SAVE this blank two-page form onto your computer.
2. COMPLETE the following form. Since this is a Word document you can add additional lines as
necessary to provide the required information.
3. EMAIL the completed form as an attachment to: email@example.com (Amanda Udis-
Kessler, IRB Chair) as well as the MR Paper Advisor with whom you are working.
I. Background Project Information (collected for all projects, including potentially exempt projects)
Name: Phone number:
Email address: MR Paper Advisor:
Briefly (in 2-3 sentences) describe the project’s methodology. How will you collect your data? Will
educational tests (cognitive, diagnostic, aptitude, achievement) be used? Classroom activities? Some
other pedagogical technique? Will audiotaping or videotaping be used?
The age range of subjects is:
If the subjects are not students in your class, who are they?
By typing your name after this statement, you indicate that you will be the legal teacher of
record when carrying out this project OR THAT YOU will have informed the appropriate
school personnel (e.g., principal, other administrators) of this project:
(Type name here) _____________________________________________________
II. Exempt Research Categories.
1. For education-related human subjects research to be exempt from routine IRB review, it must be
conducted in established or commonly accepted educational settings, involving normal educational
practices such as (1) research on regular and/or special education instructional strategies, or (2)
research on the effectiveness of or the comparison among instructional techniques, curricula, or
classroom management methods.
If your research is accurately described by the paragraph above, it will be granted exemption upon
receipt of this form with your electronic signature. Please do NOT sign the form if the above
paragraph does not describe your project. Instead, read page 2 of this form.
By typing your name after this statement, you assent that your project fits the above description
of exempt educational human subjects research:
(Type name here) __________________________________________________________
If your project does not fit the category described on page 1, it may still be exempt. However, in order
to find out, you will need to provide more information to Amanda Udis-Kessler so that she can
determine exemption status. Please use the space below to describe the project in as much detail as
possible, and email the form to Amanda at firstname.lastname@example.org or call her at 719-227-
The IRB will make all due efforts to review completed Educational Research Exemption
Determination Forms as quickly as possible. Thank you for your patience. If you have questions or
concerns, please contact Amanda at the above email address or phone number.