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Xlab Experiment Request Form


Primary Contact:
Phone #:
Email:
Department:
UCB Status:
Faculty
Graduate Student
Postdoc/Visiting Scholar

Principal Investigator/ Faculty Sponsor Name:

ABOUT YOUR EXPERIMENT

Title of Experiment:

Brief description of the experiment:


Does your experiment belong to one of the following category below?
Auctions
Bargaining/Fairness
Individual Decisions
Games
Asymmetric Information
Markets
Public Choice
Surveys
Individual Behavior
Group Behavior
Not Applicable to any of these categories

Does this experiment involve deception?
Yes
No

Is the entire experiment conducted only in the Xlab at S460 Haas?
Yes
No

Does the entire experiment use only subjects recruited by Xlab through Xlab's subject pool?
Yes
No

Does the entire experiment compensate subjects ONLY via cash-equivalent payments through the Xlab's payment facilities?
Yes
No

If you have any special procedures/requirements and room configuration needs for your experiment, please describe them below:



SUBJECT RECRUITMENT

Do you need Xlab subject recruitment services?
Yes
No

Minimum number of subjects needed per session:
Maximum number of subjects needed per session:
Total number of sessions needed:

Subject pool (Mark all that apply):
Student
Staff
Alumni (for remote online or mobile phone experiments only)

Please describe subject requirements and/or restrictions if any (i.e. gender; race; pairs, multiples of 3; similar protocol (from your series), experience with study designs like dictator games, etc.).

SUBJECT PAYMENT

Do you have funding for subject payment?
No
Yes

If yes, what is your source and amount of subject payment funding?

Xlab Grant $
Own research fund $
    Funding Contact Name (not PI)
    Funding Contact Email:
    Fund source:

Do you require Xlab subject payment services?
Yes
No

Subject Payment Type:
Flat Fee Payment
Variable Payment Range

Subject Payment Method:
Check
Amazon Gift Code


EXPERIMENT TYPE

Please choose one:
Paper Experiment
Computer Experiment
Other Experiment

Additional equipment required
What additional equipment will you use other than a laptop (e.g. webcam, projector, noise-cancelling headphones, bio-signal acquisition devices like EMG, ECG, etc.)?


COMPUTER-BASED EXPERIMENTS

Would you like to be contacted by the Technology Support Manager for a consultation?
Yes
No
What software will be used?
Firefox Browser
IE Browser
Z-tree
Inquisit
Special Software that I will provide:

Please provide additional details of your hardware and software requirements.


QUESTIONS?

Please direct CPHS-related questions to OPHS staff
You will be contacted by Xlab Administrator shortly after submitting this form.