APPLICATION FOR ETHICAL APPROVAL

			E3 FORM
APPLICATION FOR ETHICAL APPROVAL – BA level   CAIS AM GYMERADWYAETH MOESEGOL – Lefel BA
Mae’r ffurflen hon i’w chwblhau gan bob BA myfyrwyr. Rhaid i bob ffurflen gael ei ystyried gan diwtor y modiwl. Dylai un copi o’r ffurflen yn cael ei roi ar y ffeiliau Gyfadran ac un copi cadw ar y ffeil myfyrwyr.		This form is to be completed by all BA students conducting research, projects or productions. This form should be completed by the student. All forms must be considered by the Module tutor. A copy of the form must be kept centrally and on the student file.
ADRAN 1 – MANYLION MYFYRIWR		SECTION 1  –  STUDENT DETAILS
Enw Llawn Full Name
Ysgol/Cyfadran/ School/Faculty				Rhif Myfyriwr Student Number
Cydlynydd prosiect / Tiwtor Module Tutor/ Programme Co-ordinator				Enw’r Gradd Name of Degree
Teitl dangosol yr Traethawd Hir:				Indicative Title of Dissertation:

 

ADRAN 2 – MANYLION CYFRANOGWYR / CYNULLEIDFA			SECTION 2 – PARTICIPANT / AUDIENCE DETAILS
Pwy yw’r cyfranogwyr arfaethedig?		Who are the intended participants?			Ydw / Yes	Na / No
Myfyrwyr / staff Y Drindod Dewi Sant		Students / staff of Trinity Saint David
Oedolion (dros oed 16 ac yn gymwys i gydsynio)		Adults (over the age of 16 and competent to give consent)
Plant a phobl ifanc dan oed		Children / legal minors
Cleifion neu gleientiaid gweithwyr proffesiynol		Patients or clients of professionals
Rhywun sy’n cael ei gadw yn y ddalfa neu y mae’r llys wedi cymryd cyfrifoldeb amdano		Anyone in custodial care or for whom the court has assumed responsibility
Aelod o unrhyw sefydliad lle mae’n bosibl bod angen i unigolyn arall hefyd gydsynio.		A member of any organisation where another individual may also need to give consent.
Eraill:  Nodwch: / Others: please identify:
Nifer, Oed a Ffynhonnell y Cyfranogwyr Rhowch fanylion yr demograffeg y cyfranogwyr / gynulleidfa.				Participant / Audience Number and Age Provide details of the demographics of the participants / audience.
Nifer o Gyfranogwyr / yn y Gynulleidfa	Participant/ Audience number
Grŵp oedran y Cyfranogwyr/y  Gynulleidfa	Participant/ Audience age group

 

 

 

 

ADRAN 3 – GWEITHGAREDD YMCHWIL			SECTION 3 – RESEARCH ACTIVITY
1.	Ydy’r prosiect yn cynnwys:	Does the project include:		Ydy / Yes	Nac ydy/No
Defnyddio holiadur neu offeryn ymchwil tebyg		Use of questionnaire or similar research instrument
Defnyddio prawf ysgrifenedig neu gyfrifiadurol		Use of written or computerised test
Cyfweliad (cysylltwch gwestiynau posibl)		Interview (attach provisional questions)
Dyddiaduron		Diaries
Arsylwi ar gyfranogwyr a hwythau’n ymwybodol o hynny		Participant observation with their knowledge
Arsylwi ar gyfranogwyr a hwythau ddim yn ymwybodol o hynny		Participant observation without their knowledge
Recordio fideo neu sain		Video or audio-taping
Mynediad i wybodaeth bersonol neu gyfrinachol heb gydsyniad penodol y cyfranogwyr		Access to personal or confidential information without the participants specific consent
Defnyddio unrhyw gwestiynau, ysgogiadau prawf, cyflwyniad y gallai rhai cyfranogwyr eu profi fel rhywbeth sy’n achosi niwed / tramgwydd corfforol, meddyliol neu emosiynol		Administration of any questions, test stimuli, presentation that may be experienced as physically, mentally or emotionally harmful / offensive
Cyflawni unrhyw weithredoedd allai achosi embaras neu effeithio ar hunan-barch		Performance of any acts which may cause embarrassment or affect self-esteem
Ymchwilio i gyfranogwyr sy’n ymwneud â gweithgareddau anghyfreithlon		Investigation of participants involved in illegal activities
Gweithdrefnau lle defnyddir twyll		Procedures that involve deception
Gweini unrhyw sylwedd, cyfrwng neu blasebo		Administration of any substance, agent or placebo
Dull arall o gasglu data neu fformat cyflwyno (esboniwch)		Other method of data collection or presentation format (please explain)

 

 

2.	Restru eich dull o gasglu data	List your method of data collection:

 

 

3.	Risg Posibl: (corfforol, seicolegol, cyfreithiol, cymdeithasol neu economaidd)	Potential Risk: (physical, psychological, legal, social or economic)
A oes unrhyw risg bosibl i:		Is there any potential risk to:	Ydw / Yes	Na / No
A	Cyfranogwyr?	Participants?
B	Ymchwilydd?	Researcher?
C	BrifYsgol/Cyfadran?	University?

 

 

4.	Rheoli Risg: Os oes, beth yw’r risg a sut y bydd yn cael ei reoli?	Management of Risk: If yes, what is the risk and how will it be managed?

 

 

5.	Os ydych yn delio â phlant a / neu oedolion agored i niwed, rhaid i chi gyflwyno eich tystysgrif DBS i’ch tiwtor goruchwylio i’w cymeradwyo cyn i unrhyw gysylltiad â cyfranogwyr hyn.	If you are dealing with children and/ or vulnerable adults you must present your DBS certificate to your supervising tutor for approval before any contact with these participants.
				Ydw / Yes	Na / No
A	Ydych chi wedi gwneud cais am dystysgrif DBS?		Have you applied for a DBS certificate?
B	A yw eich tiwtor weld a’i gadarnhau eich tystysgrif DBS?		Has your tutor seen and approved your DBS certificate?

 

 

 

 

 

 

 

6.	A fyddwch yn cael cydsyniad gwybodus ysgrifenedig gan eich cyfranogwyr?		Will you obtain written informed consent from your participants?
						Ydw / Yes	Na / No
A	Os na fyddwch, pam hynny?			If no, why not?
B	Os byddwch, sut byddwch yn sicrhau cydsyniad gwybodus?			If yes, how will you secure informed consent?
Rhowch eglurhad / Please explain:
Cynhwyswch gopi o’r ffurflen gydsynio os ydych yn defnyddio un.				Please include a copy of the consent form if you are using one.

 

 

ADRAN 4		SECTION 4
CEFNOGWYD /APPROVED		NIS CEFNOGWYD/ NOT SUPPORTED
Datganiad Mae’r wybodaeth a gynhwysir yma yn gywir, hyd eithaf fy ngwybodaeth a’m cred.   Rwyf wedi ceisio dynodi unrhyw risgiau a phroblemau sy’n gysylltiedig â’r prosiect / ymchwil neu gynhyrchiad ac rwyf yn cydnabod f’ymrwymiadau innau a hawliau’r cyfranogwyr.			Declaration The information contained herein is, to the best of my knowledge and belief, accurate.  I have attempted to identify any risks and issues related to the project/research or production and acknowledge my obligations and the rights of the participants.
Llofnodau  Dylai’r ffurflen hon gael ei chwblhau a’i llofnodi gan y myfyriwr a’r Cydlynydd y prosiect /Twitor			Signatures This form should be completed and signed by the student and the Module tutor/Programme Co-ordinator.
Myfyriwr / Student					Dyddiad: / Date:
Cydlynydd y prosiect /Twitor Project co-ordinator / Tutor					Dyddiad: / Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

	Cyfranogwr Rhif Adnabod: Participant Identification Number:
CWESTIYNAU CYFWELIAD SAMPL	SAMPLE INTERVIEW QUESTIONS
TEITL Y PROSIECT: / PROJECT TITLE:

 

 

 

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ENW A CHYFEIRIAD YR YMCHWILYDD

NAME & ADDRESS OF RESEARCHER

 

 

 

 

	Cyfranogwr Rhif Adnabod: Participant Identification Number:
FFURFLEN GANIATÂD CYFRANOGIAD	PARTICIPATION CONSENT FORM
TEITL Y PROSIECT: / PROJECT TITLE:

 

Name of Researcher:

Please initial box

 

1. I confirm that I have read and understand the information sheet dated XXXX for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily.

 

2. I understand that my participation is voluntary and that I am free to withdraw at any time, without giving any reason.

 

3. I understand that any information given by me may be used in future reports, articles or presentations by the research team.

 

4. I understand that my name will not appear in any reports, articles or presentations.

 

5. I agree to take part in the above study.

 

 

 

________________________            ________________                                                            _____________________________

Name of Participant                            Date                                                            Signature

 

 

 

_________________________          ________________                                                            _____________________________

Researcher                                         Date                                                                    Signature

 

You may decline to participate in this study. You may end your participation in this study at any time. If you decide to remain anonymous, maintaining your anonymity will be a priority and every practical precaution will be taken to disguise your identity. If you prefer anonymity, there will not be any identifying information on audiotapes or transcripts of this or any interview. No-one will hear any audiotapes or see any transcripts without your prior consent. All materials generated from this or any interview will remain confidential.

 

When completed, please return in the envelope provided (if applicable).  One copy will be given to the participant and the original to be kept in the file of the research team at: PLACE:

 

 

ENW A CHYFEIRIAD YR YMCHWILYDD

NAME & ADDRESS OF RESEARCHER

 

 

	Cyfranogwr Rhif Adnabod: Participant Identification Number:
FFURFLEN GANIATÂD CYFRANOGIAD	SAMPLE PARTICIPANT INFORMATION SHEET
TEITL Y PROSIECT: / PROJECT TITLE:

 

 

*THIS FORM IS TO BE AMENDED AND ADAPTED AS NECESSARY

 

 

Dear Participant:

 

My name is XXXX and I am studying in the School of XXXX.

 

I would like to invite you to participate in my research project. This project will xxx and aims to xxx

 

*Attached to this letter is a short questionnaire developed by XXX which will assess XXXX. I believe your opinions will be extremely helpful to me.

 

Through your participation in the questionnaire and/or interviews, I hope to ascertain XXXX.

 

All questionnaires will be kept strictly confidential to the researchers involved and at NO time will individualquestionnaires be released to the general public. This gives you a chance to express your views on your programme a confidential and anonymous forum and still be able to make a difference. Your participation in thisstudy is completely voluntary so you can withdraw from the questionnaire at any stage.

 

Our questionnaire should take about XXX minutes to complete, but there is no time constraint. There are also no right or wrong answers. Attached to this letter along with the questionnaire is XXX (e.g. an instruction sheet / a consent form /a feedback sheet). As this is a new project, your feedback is also important to us and we would bemuch obliged if you could also complete the feedback sheet along with the questionnaire. We understand thatyour time is at a premium but your opinions are very valuable to us.

 

After careful and precise analysis of the data obtained from this questionnaire, I will be happy to provide you with a copy of the findings at your request. The results of this questionnaire will hopefully enhance my understanding of XXXX and will be stored on XXX. The results of the research will be fed back to XXX.

 

We thank you in advance for your time and participation. If any questions do arise, feel free to contact me at your convenience.

 

 

ENW A CHYFEIRIAD YR YMCHWILYDD

NAME & ADDRESS OF RESEARCHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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