Scientific Review Committee (SRC) & Institutional Review Board (IRB)
Registration, 2008 Form
| School/Local Fair:_______________________________________________________________ |
| Director:_______________________________________________________________________ |
| Director Phone:_________________________________________________________________ |
| 1) Chairperson:____________________________ Field of Study:________________________ |
| Degree(s) and/or Qualification:_____________________________________________________ |
| Institutional Affiliation:_____________________________________________________________ |
| Mailing Address: (Street)___________________________________________________________ |
| (City,State,Zip)___________________________________________________________________ |
| Phone Number:__________________________________________________________________ |
| Email Address:___________________________________________________________________ |
| 2) Member:_____________________________________ Field of Study:____________________ |
| Degree(s) and/or Qualification:______________________________________________________ |
| Institutional Affiliation:______________________________________________________________ |
| Mailing Address: (Street)____________________________________________________________ |
| (City,State,Zip)____________________________________________________________________ |
| Phone Number:____________________________________________________________________ |
| Email Address:_____________________________________________________________________ |
| 3) Member:__________________________________ Field of Study:_________________________ |
| Degree(s) and/or Qualification:________________________________________________________ |
| Institutional Affiliation:________________________________________________________________ |
| Mailing Address: (Street)______________________________________________________________ |
| (City,State,Zip)______________________________________________________________________ |
| Phone Number:______________________________________________________________________ |
| Email Address:_______________________________________________________________________ |
| The SRC must have at least three members. One member must be a biomedical scientist (Ph.D., M.D., D.V.M., D.D.S., D.O.), one a science teach, and at least one must be familiar with animal care procedures. If the SRC serves also as the IRB, one member must be a psychologist or a psychiatrist. Please return to the PBRSF, MB 3265, 4901 E. University, Odessa, TX by November 30. |