ST.

MARY’S COLLEGE OF TAGUM – RESEARCH ETHICS COMMITTEE SMCTI-

REC_FO_07
VERSION: 02
Document Submission Checklist Approval Date:
June 11, 2021
Effective Date:
June 11, 2021

Date of Submission December 8, 2022 SMCTI-REC

Protocol
Number

Researcher JANINE F. ENERIO Co-Researcher N/A

(if any)

Researcher’s Signature Researcher’s 0950-155-3020

Contact
Number

MEDIATING EFFECTOF PHYSICAL ACTIVITY ON THE

Protocol Title
RELATIONSHIP
BETWEEN SOCIAL INTERACTION AND PHYSICAL FITNESS
PERFORMANCE OF LEARNERS IN PHYSICAL EDUCATION CLASS

NO. OF COPIES DOCUMENTS SUBMITTED

1 copy Study Protocol Information Sheet

1 copy Document Receipt Form (SMCTI-REC_FO_09)

1 copy Curriculum Vitae of the Researcher (SMCTI-REC_FO_02)

1 copy Confidentiality Agreement Form for Researcher (SMCTI-REC_FO_05)

1 copy Document Submission Checklist (SMCTI-REC_FO_07)

1 copy Informed Consent/Assent forms

English
Tagalog
Cebuano

1 copy Detailed Research Protocol (Chapter 1-3 for Qualitative) and (Chapter 1&2
for Quantitative)
1 copy Minutes of Technical Review

1 copy Informed Consent Evaluation Form (SMCTI-REC_FO_12)

1 copy Protocol Evaluation Form (SMCTI-REC_FO_10)

 1 copy Self-Assessment Form (SMCTI-REC_FO_11)

1 copy TURNITIN Similarity Index Result

1 copy Routing Form

1 copy Adviser’s Endorsement Letter

1 pc. Clear Book (long & blue)

Target date of review completion and communication of SMCTI-REC decision

(2 weeks for Expedited, 3-4 weeks for Full Board):_________Date (mmm/dd/yyyy)