Thesis / Empirical Report Release Form

This form must be submitted the same day that the Thesis / Empirical Report is submitted via Canvas (Turnitin) once the student and Principal Supervisor are satisfied that the thesis is ready for submission and examination.

This form is currently only used by Clinical Psychology and Bachelor of Psychology (Hons) cohorts.

Student Name: *

Student ID Number: *

Student email: *

Course: *

Thesis Title: *

Principal Supervisor: *

Principal Supervisor's email: *

This Thesis has been prepared in accordance with the Master of Psychology (Clinical) Thesis Submission Guide on myCMI *

Yes.

Before you submit your thesis make sure it is set out correctly. The Master of Psychology (Clinical) Thesis Submission Guide can be found on my.CMI by searching the Knowledgebase (https://my.cairnmillar.edu.au/knowledgebase/masters-of-psychology-clinical-psychology-thesis-submission-guide/ )

This Thesis has been prepared in accordance with the Doctor of Psychology (Clinical) Thesis Submission Guide on myCMI *

Yes.

Before you submit your thesis make sure it is set out correctly. The Doctor of Psychology (Clinical) Thesis Submission Guide can be found on my.CMI by searching the Knowledgebase (https://my.cairnmillar.edu.au/knowledgebase/doctorate-of-psychology-clinical-psychology-thesis-submission-guide/ )

This Thesis has been prepared in accordance with the Bachelor of Psychology (Hons) Empirical Report Assessment Guide and Rubric available on Canvas. *

Yes.

This thesis has been submitted to Canvas (Turnitin)? *

Yes

Date submitted via Canvas (Turnitin): *

Supplementary Material: *

I have consulted with my Primary Supervisor about the relevant supplementary material to be submitted (e.g. data files, analysis documentation) and have uploaded the relevant files to their Research Store folder in the Central Document Library (Sharepoint).

SharePoint Folder Name: *

Should include your Project or Approval Number at the beginning of the folder name.

Statement of Authorship

"I certify that the attached material is my original work. I declare that no other person's work has been used without due acknowledgement. Except where I have clearly stated that I have used some of this material elsewhere, it has not been presented by me for examination in any other course or unit at this or any other institution.

I further declare that the ethical principles as specified by the Human Research Ethics Committee of the Cairnmillar Institute School of Psychology, Counselling and Psychotherapy have been adhered to in the preparation of this thesis.

HREC Approval / Project Number: *

If Ethics Approval was NOT required then type 'N/A' and select checkbox below.

Approval Date: *

If Ethics Approval was NOT required then type 'N/A' and select checkbox below.

If Ethics Approval was NOT required:

"None of the research undertaken required approval by a University Ethics Committee"

I certify and declare the above Statement of Authorship. *

Yes

Copyright Release

I, as the owner of the copyright for this thesis, grant The Cairnmillar Institute’s School of Psychology Counselling and Psychotherapy the right to display any or all of the thesis for use within the School and to make the thesis available to other persons for education or research purposes excluding any commercial purpose. *

I agree

Release of Thesis - Approved by Supervisor

I can confirm that my Supervisor has agreed that the Thesis is ready to be submitted for examination. *

I confirm

Declaration of Student

I declare that the thesis is my own work and has not been submitted previously, in whole or in part, in respect of any other academic award. *

I declare

If you are human, leave this field blank.