ERC Form 01: Requirements and Checklist Form
26 September 2022 Version 1
Colegio de la Purisima Concepcion
The School of the Archdiocese of Capiz, Roxas City
Roxas City 5800, Philippines
Tel. (036) 6215-331
ETHICS REVIEW COMMITTEE
REQUIREMENTS AND CHECKLIST
PROTOCOL INFORMATION
Research (Working) Title:
Researcher(s):
Email
Contact No:
Address:
Affiliation:
Adviser:
Co-Adviser:
To be accomplished by SGS/CRESA personnel
Date of Submission:
(Accomplished by ERC
Personnel)
Verified Complete:
(Accomplished by ERC/SGS
Personnel)
Review Classification:
Full Committee Review Exempted Review
(Accomplished by CPC-ERC)
Classified on:
Classified By:
(DD Month
(Accomplished by CPC-ERC)
YYYY)
BASIC DOCUMENTS
Letter of Request addressed to the Dean of the School of Graduate Studies Three (3) Printed Copies
CPC-ERC Form 01: Requirements and Checklist Three (3) Printed Copies
CPC-ERC Form 02: Registration and Application Form Three (3) Printed Copies
CPC-ERC Form 03: Research Protocol and Informed Consent Assessment Form
OR Three (3) Printed Copies
CPC-ERC Form 04: Review Exemption Form
Research Protocol (with appendices/annexes, version number, & version date)
Paper Size: Letter (8.5” by 11”) Three (3) Printed Copies
Font Type: Century Gothic
Font Size: Size 12
Data Collection Forms (as appended) Three (3) Printed Copies
Page 1 of 2 Center for Research and Statistical Analysis
ERC Form 01: Requirements and Checklist Form
26 September 2022 Version 1
Informed Consent Forms in English and/or Filipino (as appended) Three (3) Printed Copies
Curriculum Vitae of the Researcher (as appended) Three (3) Printed Copies
Technical Review Certification and/or Endorsement
Three (3) Printed Copies
(attached as preliminary page in protocol)
Electronic copies (in PDF file) of the following documents:
(a) research protocol and accompanying appendices Submitted in one (1) CD / submitted to the
(b) CPC-ERC Form 01 email that will be provided by the School of
(c) CPC-ERC Form 02 Graduate Studies
(d) CPC-ERC Form 03
Photocopy of Official Receipt for ethics review fee (see review fee below) One (1) Photocopy
STUDY-SPECIFIC DOCUMENTS
Research intervention/experiment and intervention protocol
Three (3) Printed Copies
(for experimental or interventional studies)
Assent Forms in English (for studies involving minors and relevant populations
Three (3) Printed Copies
deemed incompetent to sign an informed consent form; appended in protocol)
Assent Forms in Filipino (for studies involving minors and relevant populations
Three (3) Printed Copies
deemed incompetent to sign an informed consent form; appended in protocol)
Previous ethical review approvals or clearances (for those with prior ethical
Three (3) Printed Copies
review)
CPC Ethics Review Committee Payment Fee
Undergraduate Student Researches PHP 2,000.00
Post-Graduate Student Researches (MA or PhD ) PHP 2,000.00
Faculty-Initiated Researches PHP 2,000.00
Page 2 of 2 Center for Research and Statistical Analysis
