If there is more than one IRB, indicate the IRB or IRBs to which the individual is a member. CHECK ALL THAT APPLY

Abbreviate

Scientist/Nonscientist - Members whose training, background, and occupation would incline them to view scientific activities from the standpoint of someone within a behavioral or biomedical research discipline should be considered a scientist, while members whose training, background, and occupation would incline them to view research activities from a standpoint outside of any biomedical or behavioral scientific discipline should be considered a nonscientist. In addition, the IRB must have members with sufficient knowledge of the specific scientific discipline(s) relevant to the research that it reviews.

Describe the populations about whom the members is knowledgeable of or experienced in working with. (e.g., children, pregnant women, prisoners, economically disadvantaged, educationally disadvantaged, cognitively impaired adults or Native Americans.

Provide brief descriptors of all relevant experiences that describe each member's chief anticipated contributions to IRB deliberations, such as professions, life experiences with research or vulnerable populations, research experiences, IRB experiences, certifications and licensures or other information as appropriate. Examples: “Board certified in pediatrics and pediatric cardiology. Assistant Professor of Pediatrics. Clinical investigator studying cardiac devices. Chair of Pharmacy and Therapeutics Committee.” “Accountant. Mortgage Officer at local bank. Parent died of Alzheimer Disease. Volunteer family counselor for local Alzheimer Support Group. IRB member since 2001.”

E.g., current or former employee, consultant, Board of Directors, volunteer, trainee or student. If the organization has multiple components, include both the relationship and the component with which the member has a relationship. Examples: “Retired faculty of ABC University” “Medical staff of ABC Hospital”.

Indicate "Affiliated" or "Nonaffiliated" indicating whether the IRB member or any of the member’s immediate family is affiliated with the organization (USM).

Are you a Chair or Vice Chair?

E.g., member, alternate member or non-voting. If a member serves ex officio indicate whether the member is a voting member.