GEORGE WASHINGTON UNIVERSITY TRANSLATORBACKTRANSLATOR FORM IF YOU ARE PLANNING

FOR CANDOR • DRYDEN • GEORGE JUNIOR REPUBLIC
INTRODUCTORY GEOLOGY GEOLOGY 101 GEORGE MASON UNIVERSITY FALL
QUEEN’S HOSPITAL ROMFORD KING GEORGE HOSPITAL GOODMAYES

02 OCFS INF01 MARCH 5 2002 GEORGE E PATAKI
02 OCFS LCM16 AUGUST 21 2002 GEORGE E PATAKI
04OCFSINF05 JUNE 18 2004 GEORGE E PATAKI GOVERNOR NEW

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George Washington University

Translator/Back-Translator Form


If you are planning to work with populations who are not proficient in English, you must include the English versions, translations, and back-translations of the informed consents/information sheets/assent forms, and questionnaires/interview questions in your submission. In addition, please include a completed copy of this form with your submission. Should you have any questions, please contact the Office of Human Research at (202) 994-2715.


  1. Principal Investigator Information


Name:      

Study Title:      


Signature      __________________________________ Date      ___________________

  1. Translator information


Name of translator:      


Background in language:

  1. Native speaker

  2. Hold a degree/certificate in language

3. Other, please specify:      

Signature      __________________________________ Date      ___________________


  1. Back-translator information: This cannot be the same person who provided the first translation and must be unaffiliated with the study.


Name of back-translator:      


Background in language: (please circle)

  1. Native speaker

  2. Hold a degree/certificate in language

  3. Other, please specify:      


Signature      __________________________________ Date      ___________________



04OCFSLCM02 JUNE 4 2004 GEORGE E PATAKI GOVERNOR NEW
04OCFSLCM16 OCTOBER 26 2004 GEORGE E PATAKI GOVERNOR NEW
04OCFSLCM21 DECEMBER 14 2004 GEORGE E PATAKI GOVERNOR NEW


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