ࡱ>   |bjbj eesQ( ( d:Kh("@@@TKVKVKVKVKVKVK$=NPlzK{{{zK@@Ka$a$a${R@@TKa${TKa$a$0FDH@ءtG&@KK0KGn[Q!Z[QLH[QH8|a$EdzKzK#HK{{{{[Q( H:  91ܽ Institutional Review Board INSTRUCTION SHEET Application for Full/Expedited Review of Research Involving Human Subjects PLEASE DO NOT INCLUDE THIS INSTRUCTION SHEET OR ANY SAMPLE FORMS WITH YOUR APPLICATION SUBMISSION. Please answer all questions to the fullest extent possible, attach additional pages as required. If a question is not applicable to your research, write "NA", do not leave blanks. Do not change order or omit questions. All attachments must be labeled and sequentially ordered as individual appendix items. Be sure to refer to each appendix in the body of the application. The application must have original signatures of the investigator(s), including faculty sponsor(s) in case of student projects, and department chair. If you are required to revise the application and to return it to the IRB, new signatures and dates are necessary to show that all parties have approved of all revisions. The IRB will not review protocols submitted by students without the signature of a faculty advisor on the application. As of September 1, 2004 all 91ܽ personnel (including students and staff) involved in projects using human research subjects who have not completed the 91ܽ workshop, Education in the Protection of Human Research Subjects, are required to complete an online training program before beginning their research. To complete the training titled Protecting Human Research Participants go to  HYPERLINK "http://phrp.nihtraining.com" http://phrp.nihtraining.com . Once the training module has been completed, you will be prompted to print out a certificate of completion. A copy of this certificate must be submitted with your IRB application or your application will be returned. Please keep a copy of your certificate for your records as it must be attached to all future IRB applications as proof of training compliance. If research takes place at another facility, that facility and/or its Institutional Review Board must also approve of the project before subjects may be enrolled. Using the following checklist, and depending on the nature of the study, the application should include: ___ All required signatures ___ Training certificate(s) attached ___ Consent form(s) and Assent form(s) that will be given to human subjects ___ Copy of scripts, posters, flyers, and letters to be used to recruit subjects ___ Narrative script for any audio or videotape used during data collection ___ Cover letter(s) to accompany a survey instrument ___ Complete copy of newly developed survey instruments ___ Full citation for standard or published instruments ___ Copy of standard or published instruments with your modifications ___ Any screening tools used to establish inclusion or exclusion (for example, demographic or medical history data forms) ___ Letter of permission to use an off-campus site. ___ One copy of full application if research is being submitted to an external agency for funding (i.e., NIH, private foundation, etc.). Applications must be typed and pages numbered in sequence; if not typed, the application will be returned without review. This instruction page should not be submitted to the IRB. Please spell-check before submitting. Project ID#___________________________ (OSR Use Only) LONG ISLAND UNIVERSITY INSTITUTIONAL REVIEW BOARD All investigators are expected to be familiar with LIU policies and procedures governing the use of human subjects in research. Failure to follow application instructions may result in delay of the approval process. All LIU personnel (including students and staff) involved in projects using human research subjects are required to complete an online training program before beginning their research. To complete training go to  HYPERLINK "http://phrp.nihtraining.com" http://phrp.nihtraining.com and submit a copy of the certificate of completion from that program as part of this application. (Protecting Human Research Participants) Please send one copy of the completed application to: Inter-Departmental Mail: Patricia Harvey, Sponsored Research, University Center Regular Mail: Patricia Harvey, IRB, LIU, Office of Sponsored Research, 700 Northern Blvd., Greenvale, NY 11548 Project Title:* ________________________________________________________________ ______________________________________________________________________________ (*If part of a larger program and/or if funded by an external agency, also provide the title of the larger program and/or grant title:___________________________________________ _____________________________________________________________________________) A. INVESTIGATORS: LIU Faculty Investigator / Sponsor: _________________________________________________ Department: ___________________________________________________________________ Campus: ______________________________________________________________________ Phone: ______________________Fax: ___________________Email: ____________________ Student Investigator: __________________________________________________________ Department: ___________________________________________________________________ Campus: _____________________________________________________________________ Phone: _______________________Fax: __________________Email:____________________ Address for Correspondence ______________________________________________________ ______________________________________________________________________________ On a separate sheet list any co-investigator(s) and affiliations(s); be sure to identify personnel who are not employees or students of LIU. Type of project (check one): ____Faculty research __Doctoral dissertation _____Pre-doctoral research _____Masters thesis ___ Pilot study ____Other (specify): B. SOURCE OF FUNDING: 1. ___Externally Funded Sponsor and Sponsor ID: ___________________________________________________ 2. ___Seeking Funding: Sponsor: ____________________________________Deadline:____________________ A full copy of the grant proposal must be on file with the University Office of Sponsored Research or appended to this application. _______On File _______ Appended 3. ________ Not Seeking Funding C. DATA COLLECTION: 1. Data collection, proposed dates: _________________________________________________ (Note: the start date for collection must be no earlier than the date full approval is received.) 2. Site(s) of data collection: _______________________________________________________ 3. If the proposed activities be conducted in whole or in part at another institution/organization, provide name(s) of participating institution(s) and indicate their role(s) in the study. If the subjects are to be drawn from an institution or organization [i.e., hospital, social service agency, employer, prison, school, etc.] which has responsibility for the subjects, then documentation of permission from that institution and its IRB or equivalent must be submitted before final LIU approval can be given. ______________________________________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ Other organizations may require that you also receive HIPPA permission from an appropriate office or officer at their site. If required, a copy of the HIPPA approval should be attached. (Note: 91ܽ is not a covered entity under HIPPA considerations. E. SUMMARY OF PROPOSED RESEARCH: Provide a brief description, in laymans terms, of the proposed research. The description must include the purpose of the research and a summary of the procedures to be used with the subjects. This section should also indicate the roles of each investigator, co-investigator and/or research study personnel. Please limit your summary to one page. F. SUBJECTS: 1. Number of subjects: #Males _________; #Females____________ #Total____________ 2. Subject Population (check all that apply): _____Adults _____Minors (under 18)* _____Prisoners* _____Mentally Impaired* _____Physically Ill* _____Disabled* _____Pregnant Women* _____Students* _____Special racial or ethnic group (specify)*_______________ *Rationale for use of special groups or subjects whose ability to give voluntary informed consent may be in question, must be fully explained and justified below. 3. What are the criteria for inclusion and/or exclusion of subjects? The basis of exclusion from the study should be stated when subjects are asked to complete screening questionnaires. 4. Initial Contact and Subject Selection. Describe how subjects will be identified and recruited. Describe who will make initial contact, and how it will be made. If subjects are chosen from records, indicate who gave approval for use of the records. Written documentation of the cooperation/permission from the holder or custodian of the records must be attached. (The official holder of the record, i.e. primary physician, therapist, or public school must make initial contact of subjects identified through records search official.) Be precise and attach a copy of any and all recruitment materials to be used (e.g., advertisements, flyers, letters, scripts). 5. Will subjects receive any inducements before participating or rewards or compensation after participating? ____Yes ____No If Yes, please describe how much and in what form (cash, travel expenses, meals, lottery, etc.) and when participants will receive it (upon completion, after each session, if subjects withdraw from study etc.) This information must also be included in the consent form. If using lottery or raffle, describe who will be responsible for conducting, the location for the drawing, and under whose supervision. G. RISKS: 1. Do any of the procedures involve physiological treatments or intervention/invasion of the body by mechanical, electronic, biological or any other means? ____Yes ____No If Yes, describe in detail the intervention, the means to administer the intervention, the behavior expected of subject(s) and the behavior of the investigator during the administration of the intervention; how data will be gathered and recorded; identify any anticipated and possible consequences of the procedure for the subject(s); what steps will be taken to assure proper operation and maintenance of the means used to administer the intervention; competence/qualifications of investigator; and name, title, affiliation, telephone number of individual who will supervise the procedure. 2. Does the study involve the administration of any prescribed or proscribed drugs? ____Yes ____No If Yes: a. Name the drug(s): _______________________________________________________ __________________________________________________________________________ b. Is it: _____prescribed or _____ proscribed Describe the dosage:____________________________________________________ __________________________________________________________________________ Route of administration:_________________________________________________ __________________________________________________________________________ e. Is this an FDA-approved use? ___Yes ___No f. Will the subject be at risk of harm in any way? ____Yes ____No If Yes, identify type of harm; possibility that it will occur; action(s) to be taken to lessen possibility of occurrence; and action(s) to be taken in case of an adverse reaction. 3. Identify anticipated and possible physiological consequences of this procedure for the subject(s); identify the site where the procedure/administration is to be carried out; indicate the investigators competence/qualification to conduct this procedure; and give name, title, affiliation, and phone number of individual who will supervise the procedure. 4. Do you deceive subjects in any way? _____Yes _____No (A study is deceptive if false information is given to subjects, false impressions created, or information relating to the subjects participation is withheld.) If Yes, describe in detail the deception involved, including any instructions to subjects or false impressions created; why deception is necessary to accomplish the goals of the research; and plan for debriefing subjects. Attach a copy of any debriefing statement. 5. Does the research involve subjects who are likely to be vulnerable to coercion or undue influence, such as children (under 18), prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons? _____Yes _____No If Yes, what, if any, additional safeguards have been included to protect the rights and welfare of these subjects? 6. Does the research involve any of the following? a. Major changes in diet or exercise? ____Yes ____No If Yes, describe: b. Administration of physical stimuli other than auditory and visual stimuli associated with normal classroom activities? ____Yes ____No If Yes, describe: c. Use of a new medical device? ____Yes ____No If Yes, describe: d. Possible invasions of privacy of subjects, or their families, including use of personal or medical information? ____Yes ____No If Yes, describe: e. Any probing for information that might be considered personal or sensitive, or might make a subject feel demeaned, embarrassed, appreciably anxious, or his or her privacy violated? ____Yes ____No If Yes, describe: f. Any procedure involving invasion of the body, i.e., touching, contact, attachment to instruments, withdrawal of specimens? ____Yes ____No If Yes, describe: g. Presentation to the subject of any materials that he/she might find offensive, threatening or degrading? ____Yes ____No If Yes, describe: Describe any other possible risks not mentioned above. 7. For any procedures involving potentially substantial risks to the physical, psychological or social welfare of the human subjects, explain why your selected methodology is preferable to or outweighs any alternative approaches. 8. If there are any substantial risks cited above, assess their likelihood and seriousness. a. Describe the procedures for protecting against or minimizing these risks. b. Describe alternative and accepted procedures or methods of treatment, if any were considered, and why they will not be used. c. Describe why these risks are reasonable in relation to the anticipated benefits. H. CONFIDENTIALITY OF DATA: Specify the steps to be taken to guard the anonymity of subjects and/or the confidentiality of their responses. Safeguards to protect confidentiality should be spelled out in the consent form and should include a description of the ultimate disposal of data. 1. Please explain how data confidentiality will be maintained. (i.e. coding, removal of identifiers, limitation of access to data, etc.) 2. How will your data be stored? Please note: Data must be stored for a minimum of three years after completion of the study before destroyed as per federal guidelines. 3. Will you gather information from a subject while a recording (visual and/or aural) is taking place? ____Yes ____No If Yes, explain what safeguards will be employed to protect confidentiality of data, i.e., coding, removal of identifiers, limitation of access to data, locked file cabinets, black out of faces, etc. Also complete question #4: (You will need special permission for taping outlined in the consent form.) 4. If Yes to answer 3, please clarify if the tapes will be used for only research purposes or for educational purposes. I. INFORMED CONSENT: Informed consent is necessary for all research involving human subjects and must be documented. Use of subjects unable to give personal consent for reasons of age, mental state, legal or other such status, requires that consent be secured from parents or legal guardians. Attach a clean original of the written consent form to this application. Please do not include these instructions or sample forms with your submission. At the end of the review process, this will be stamped with IRB approval and returned. If consent will be presented orally, a written copy (verbal script) of the oral presentation must be submitted. The Principal Investigator must sign the consent along with the participant. Requirements for Informed Consent Be sure to provide the prospective subjects with sufficient opportunity to consider whether or not to participate. Do not coerce or use undue influence that would affect a subject's decision to participate. No subject may be involved in research unless the subject's prior written consent has been obtained. The consent form should be in language that subjects can easily understand (8th grade level). Review the instructions below before preparing the consent form. Be sure to submit an original copy of the consent form as an attachment to the IRB application. A well-written consent form should include the following: 1. statement identifying the researcher as LIU faculty or LIU student fulfilling degree requirements; 2. statement that the study involves research; 3. statement of the purpose(s) of the research; 4. time required for the subject's participation; 5. description of the procedures to be followed and identification of any that are experimental; 6. description of any reasonably foreseeable risks or discomforts to the subjects; 7. description of any benefits to the subject or to others that may reasonably be expected from the research; 8. disclosure of appropriate alternative procedures or courses of treatment, if any, which might be advantageous to the subject; 9. statement describing the extent to which confidentiality of records identifying the subject will be maintained; 10. for research involving more than minimal risk, an explanation as to whether there will be any compensation and an explanation as to whether any medical treatments are available if injury occurs and, if so, what they consist of, or where further information may be obtained; 11. an explanation of whom to contact for answers to pertinent questions about the research and subjects' rights; 12. the name of the person to contact in the event of a research-related injury to the subject; and 13. statement that participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which the subject is otherwise entitled; the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled; withdrawal will not effect subject's relationship with LIU or with any other organization or institution. When appropriate, one or more of the following elements of information should also be provided to each subject: 14. statement that the particular treatment or procedure may involve risks to the subject (or to the embryo or fetus, if the subject is or may become pregnant) that are currently unforeseeable; 15. anticipated circumstances under which the subject's participation may be terminated by the investigator without regard to the subject's consent; 16. any additional costs to the subject that may result from participation in the research; 17. consequences of a subject's decision to withdraw from the research and procedures for orderly termination of participation by the subject; 18. statement that significant new findings developed during the course of the research which may relate to the subject's willingness to continue participation will be provided to the subject; and 19. approximate number of subjects involved in the study. Following are sample consent forms and assent form. Using the items listed above, please revise this form so that it meets the requirements of your research project. Whenever possible, the consent should be on institutional letterhead; if not, then the heading shown on the sample should be used. SAMPLE FOR FACULTY/STAFF/ADMINISTRATORS LONG ISLAND UNIVERSITY/ (INSERT CAMPUS NAME) Informed Consent Form for Human Research Subjects You are being asked to volunteer in a research study called (INSERT TITLE OF PROJECT), conducted by (INVESTIGATORS NAME, POSITION, DEPARTMENT). The purpose of the research is (SHOULD BE IN LAYMANS LANGUAGE). As a participant, you will be asked to (DESCRIBE THE PROCEDURES AND TIME INVOLVED, SITE, DATES, POSSIBLE RISKS AND/OR DISCOMFORT.) Of these procedures, the following are experimental (IF APPLICABLE, LIST EXPERIMENTAL PROCEDURES). While there is no direct benefit for your participation in the study, it is reasonable to expect that the results may provide information of value for the field of (INSERT FIELD) Your identity as a participant will remain confidential. Your name will not be included in any forms, questionnaires, etc. This consent form is the only document identifying you as a participant in this study; it will be stored securely in (IDENTIFY LOCATION) available only to the investigator (IF APPLICABLE, LIST OTHERS WHO MAY HAVE ACCESS). Data collected will be destroyed at the end of three years (OR if you will storE the data for further research, replace the statement, destroyed at the end of three years with Data collected will be kept for further research) Results will be reported only in the aggregate. (EXPLAIN OTHERWISE IF THIS IS NOT THE CASE.) If you are interested in seeing these results, you may contact the principal investigator. For research involving more than minimal risk, (INCLUDE SAME INFORMATION DESCRIBED IN SECTION H ABOVE). (NOTE: REVIEW ITEMS 1 THROUGH 19 ABOVE FOR ADDITIONAL INFORMATION YOU MAY NEED TO INCLUDE.) If you have questions about the research you may contact the investigator, (NAME, OFFICE PHONE) or the department chair, (NAME, OFFICE PHONE). If you have questions concerning your rights as a subject, you may contact the Executive Secretary of the Institutional Review Board, Ms. Patricia Harvey at (516) 299-3591. You may contact (NAME, TITLE, and PHONE NUMBER) for answers to any questions you may have in relation to a research-related injury. (INCLUDE THIS STATEMENT ONLY IF YOUR PROJECT HAS ANY RISK OF PHYSICAL INJURY.) Your participation in this research is voluntary. Refusal to participate will involve no penalty or loss of benefits, and you may discontinue participation at any time without penalty or loss of benefits to which you are otherwise entitled. You have fully read the above text and have had the opportunity to ask questions about the purposes and procedures of this study. Your signature acknowledges receipt of a copy of the consent form as well as your willingness to participate. ___________________________________________ Typed/Printed Name of Participant ___________________________________________ ______________ Signature of Participant Date __________________________________________ Typed/Printed Name of Investigator __________________________________________ ______________ Signature of Investigator Date SAMPLE FOR STUDENT PROJECTS LONG ISLAND UNIVERSITY/ (INSERT CAMPUS NAME) Informed Consent Form for Human Research Subjects You are being asked to volunteer in a research study called (INSERT TITLE OF PROJECT), conducted by (STUDENT INVESTIGATORS NAME, DEPARTMENT) under the supervision of (INSERT FACULTY SPONSORS NAME, POSITION, DEPARTMENT). The purpose of the research is (SHOULD BE IN LAYMANS LANGUAGE). As a participant, you will be asked to (DESCRIBE THE PROCEDURES AND TIME INVOLVED, SITE, DATES, POSSIBLE RISKS AND/OR DISCOMFORT.) While there is no direct benefit to you for participation in the study, it is reasonable to expect that the results may provide information of value for the field of (INSERT FIELD) Your identity as a participant will remain confidential. Your name will not be included in any forms, questionnaires, etc. This consent form is the only document identifying you as a participant in this study; it will be stored securely in (IDENTIFY LOCATION) available only to the investigator (IF APPLICABLE, LIST OTHERS WHO MAY HAVE ACCESS). Data collected will be destroyed at the end of a legally prescribed period of time OR stored for further research. (SPECIFICALLY STATE IF DATA WILL BE KEPT OR IF IT WILL BE DESTROYED) Results will be reported only in the aggregate. (EXPLAIN OTHERWISE IF THIS IS NOT THE CASE.) If you are interested in seeing these results, you may contact the principal investigator. For research involving more than minimal risk, (INCLUDE SAME INFORMATION DESCRIBED IN SECTION H ABOVE). (NOTE: REVIEW ITEMS 1 THROUGH 19 ABOVE FOR ADDITIONAL INFORMATION YOU MAY NEED TO INCLUDE.) If you have questions about the research you may contact the investigator, (NAME, OFFICE PHONE) or the faculty sponsor, (NAME, OFFICE PHONE). If you have questions concerning my rights as a subject, you may contact the Executive Secretary of the Institutional Review Board, Ms. Patricia Harvey at (516) 299-3591. You may contact (NAME, TITLE, and PHONE NUMBER) for answers to any questions you may have in relation to a research-related injury. (INCLUDE THIS STATEMENT ONLY IF YOUR PROJECT HAS ANY RISK OF PHYSICAL INJURY.) Your participation in this research is voluntary. Refusal to participate or discontinue participation at any time will involve no penalty or loss of benefits to which you are otherwise entitled. Your signature indicates you have fully read the above text and have had the opportunity to ask questions about the purposes and procedures of this study. Your signature also acknowledges receipt of a copy of the consent form as well as your willingness to participate. ___________________________________________ Typed/Printed Name of Participant ___________________________________________ ______________ Signature of Participant Date __________________________________________ Typed/Printed Name of Investigator __________________________________________ ______________ Signature of Investigator Date SAMPLE ASSENT FORM (UNDER 18) LONG ISLAND UNIVERSITY/ (INSERT CAMPUS NAME) Assent Form for Human Research Subjects Title: Principal Investigator: Supervising Investigator: Why are you here? The researchers (thats us) want to tell you about a study looking at how. We want to. We decided to invite you to be in the study because we want to learn more about.and because your parent or guardian thought you might like to be in the study too. Why is this study being done? We want to learn more about. What will happen to me? Only if you want, these things will happen: Answer questions about. Play with toys while we watch you. Will the study hurt? Nothing in this study will hurt. Will the study help me? What if I have questions? You can ask us questions any time. You can ask questions now or later. You can talk to any of the people who are helping with the study. Do my parents know about this? This study was explained to your parents and they said that you could be in it. You can talk this over with them before you decide. Do I have to be in the study? You do not have to be in the study. No one will be upset if you dont want to do this. If you dont want to be in this study, you just have to tell us. If you want to be in the study, you just have to tell us. You can say yes now and change your mind later. Its up to you. Writing your name on this page means that the page was read by you or to you and that you agree to be in the study. You know what will happen to you. If you decide to quit the study all you have to do is to tell the person in charge, ________________________________ __________________ MY NAME TODAYS DATE ________________________________ ___________________ INVESTIGATORS SIGNATURE DATE APPLICATION ENDORSEMENTS Applications will not be reviewed without the appropriate endorsements. Principal Investigator: I certify that a) the information provided for this project is accurate; b) no other procedures will be used in this project; and c) any modifications in this project will be submitted for approval prior to use. _______________________________________________ _______________________ Signature of Investigator Date Faculty Supervisor: I certify that this project is under my direct supervision and that I am responsible for insuring that the investigator complies with all provisions of approval. ________________________________________________ _____________________ Signature of Faculty Sponsor Date Department Chair: My signature below certifies that I have reviewed this research protocol and that I attest to the scientific merit of this study and the competency of the investigator(s) to conduct the project. __________________________________ Printed Name of Department Chair _________________________________________ ___________________ Signature of Department Chair Date NOTE: APPROVAL OF THIS PROJECT BY THE IRB ONLY SIGNIFIES THAT THE PROCEDURES ADEQUATELY PROTECT THE RIGHTS AND WELFARE OF THE SUBJECTS AND SHOULD NOT BE TAKEN TO INDICATE UNIVERSITY APPROVAL TO CONDUCT THE RESEARCH     Version January 2015 PAGE  PAGE 12 456Xg q r ɶyiyZyOy=yi"hwIGhI"56CJOJQJaJhwIGhI"CJaJhwIGhTQCJOJQJaJhwIGhI">*CJOJQJaJhwIGhI"CJOJQJaJh3phAk5B*OJQJph h8',h3p5B*OJQJphh3ph3pOJQJh3phI"OJQJh3pCJaJh3phI"CJaJhwIGCJaJhwIGh3pCJOJQJaJhwIGhI"CJOJQJaJ hI"55Hq r + , ./%x1^gdwIG`gdW$a$gdwIG HdhgdwIG H +  @AӴyiZK>hI"5CJOJQJaJhgChWCJOJQJaJhwIGh"CJOJQJaJhwIGh"5CJOJQJaJhwIGhBQCJOJQJaJ h>uhT0JCJOJQJaJhThTCJOJQJaJhTCJOJQJaJjhTCJOJQJUaJhwIGh*J%CJOJQJaJhwIGh#8CJOJQJaJhwIGhWCJOJQJaJhwIGhI"CJOJQJaJ %.ಢscSC?5h]chb@5CJhI"hwIGhI"6CJOJQJaJhwIGh8',6CJOJQJaJhwIGhC6CJOJQJaJhwIGhC5CJOJQJaJ"hwIGhI"5>*CJOJQJaJhj5CJOJQJaJhwIGh>05CJOJQJaJhwIGhI"5CJOJQJaJhwIGhXCJOJQJaJhwIGhWCJOJQJaJhwIGhI"CJOJQJaJhwIGhwIG5CJOJQJaJ1i)]4OP Yjkldhgdb@^gd]cgdTQgdb@$a$gdb@ 0^`0^ OP()*+  )*EFGʺzn_nzNzn>hwIGhJ66CJOJQJaJ h>uhC0JCJOJQJaJhChCCJOJQJaJhCCJOJQJaJjhCCJOJQJUaJhwIGhgC6CJOJQJaJhwIGhC6CJOJQJaJhwIGh8F6CJOJQJaJhwIGhO 6CJOJQJaJhwIGhI"6CJOJQJaJ hTQhTQhI" hChb@hChb@CJ hb@5CJhb@ "%*1gjoxjkl&˼˭wnfVF;fhb@5>*OJQJhwIGhb@5CJOJQJaJhwIGhb@5CJOJQJaJhb@OJQJhb@5OJQJhI"OJQJhwIGh8F5CJOJQJaJh>156CJOJQJaJhb@56CJOJQJaJh5?56CJOJQJaJho56CJOJQJaJ"hwIGh]c56CJOJQJaJ"hwIGh8F56CJOJQJaJhwIGhI"6CJOJQJaJl&uiY5S]tdhgd'h^hgd'gd'dh`dh^dhgdb@ dh^gdb@dhgdb@&u45Siut~K L p >!?!!!ɮɥɥɖуѳ):6Oϴ=6Oϴ96Oϴ5ϴ"5>*ϴǥ5>*ϴ''6Oϴϴ'5>*ϴ<9OJQJh'OJQJh9OJQJh9 OJQJhI"OJQJh]chb@OJQJhb@OJQJhb@$to p `!!"#$W$$&&&&&''''''dhgd<9gd8',dhdhgd'gd' hdh^hgd'_!`!!!!!"3#p#~#W$$$%%&&&&&&)&*&H&S&T&Y&&&a'~sh_WOh OJQJhOJQJhI"5OJQJhd5>*ϴ#5>*ϴYɱ6Oϴɱ6Oϴ6Oϴa6Oϴu6Oϴuϴ<9OJQJh>ϴ9ϴr&"5Oϴ8',ϴ"5>*ϴ"ϴ9"ϴ''''''''''(((((((((((((((())$)%))))********9+:+,ź멡롉u䴳ϴϴ#ϴ2ϴ9ϴuϴ<9OJQJhI">*OJQJhI"5>*OJQJh5>*OJQJh]c5>*OJQJhwIGOJQJhTQOJQJhI"OJQJhuh5OJQJ+''''''''''''''''''''''''''''''''''''''''(I(p(((($)))))))****$a$gd2dh `0dh^`0*****:+,1-2-3-4-5-6--[/\/]/^/_/`/a/k/l/ 0!0p2$a$gdnc$a$gdu & Fgdgd,1-2-6-7------.. .Y...Y/Z/[/\/`/a/b/j/k///$0'022h5k5667777h8k8޽޵ޭƭޥޭޝ~޵޽޽޽vvnf޽hTQOJQJhr&OJQJh~OJQJhI">*OJQJhI"5>*OJQJh5>*OJQJhz8&OJQJh~OJQJh2OJQJh9OJQJhI"5OJQJhncOJQJh^y5OJQJhAMOJQJhI"OJQJh9huOJQJhhCJOJQJaJ(p2q2r2s2t2u2v2w2x2222;3334O4445e566 $^a$gd~ & Fdh$dha$ $dh^a$dh`$`a$$a$67777777777e8p9q9r9s9t9u9v9w9x9|::(;u;v;w;$`a$$a$gd< 8$a$k8::#;';(;f;i; 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