Parental or Guardian's Consent for Child to Participate in by 3e6gVny

VIEWS: 3 PAGES: 3

									A                                          Sample A

        Parental/Guardian's Consent for Child to Participate in Research Project:
          9th-Graders' Perspectives on Using the World Wide Web to do Schoolwork

    Use this type of PARENTAL/GUARDIAN CONSENT FORM for research projects that
    involve:

        Participants who are MINORS (Age 17 and under) = Therefore, the researcher
         must obtain not only the minors assent (a separate document, not listed in this
         file), but the consent/permission of the minor's parent/guardian for the minor to
         participate.

        Interviews

        Researcher has a pre-existing relationship with participants (e.g., researcher is a
         teacher and the participants are that teacher's students; researcher is a service
         provider and the participants are that service provider's current or prospective
         clients)


                      See Sample A Consent Form on Following Pages




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A                                      University of Hawai'i

         Parental/Guardian's Consent for Child to Participate in Research Project:
           9th-Graders' Perspectives on Using the World Wide Web to do Schoolwork

    My name is Kainoa Researcher. I am your child's 9th grade science teacher at Hoku High
    School. I also am a graduate student at the University of Hawai’i at Manoa (UH), in the
    Department of Curriculum Studies. One requirement for earning my Master's degree is to
    do a research project. The purpose of my research project is to evaluate high school
    students' perspectives on using the World Wide Web (Web) to do their schoolwork. I am
    asking your permission for your child to participate in this project. I also will ask your
    child if s/he agrees to participate in this project.

    Project Description - Activities and Time Commitment: If your child participates, I
    will interview him/her once during lunch period, in a small room, by the front office of
    Hoku High School. The interview will last for about 25 to 30 minutes. Your child and I
    (no one else) will be present in the room during the interview. I will record the interview
    using a digital audio-recorder. I am recording the interview so I can later type a transcript
    – a written record of what we talked about during the interview - and analyze the
    information from the interview. If your child participates, s/he will be one of a total of six
    to eight 9th-graders that I will interview individually. One example of the type of
    question I will ask is, “What do you find most and least useful about using the Web to do
    homework?” If you would like to see a copy of all of the questions that I will ask, please
    contact me via the phone number or email address listed near the end of this consent
    form.

    Benefits and Risks: I believe there are no direct benefits to your child for participating in
    my research project. However, the results of this project might help me, other teachers,
    and researchers learn more about high school students' perspectives on using the Web for
    schoolwork. I believe there is little or no risk to your child in participating in this project.
    If, however, your child becomes uncomfortable or stressed by answering any of the
    interview questions, we will skip the question, or take a break, or stop the interview, or
    withdraw from the project altogether.

    Confidentiality and Privacy: During this research project, I will keep all data from the
    interviews in a secure location. Only my University of Hawaii advisor and I will have
    access to the data, although legally authorized agencies, including the University of
    Hawai'i Human Studies Program, have the right to review research records.

    After I transcribe the interviews, I will erase the audio-recordings. When I report the
    results of my research project and in my typed transcript, I will not use your child's name
    or any other personally identifying information. Instead, I will use a pseudonym (fake
    name) for your child. If you would like a copy of my final report, please contact me at the
    number listed near the end of this consent form.



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Voluntary Participation: Participation in this research project is voluntary. Your child
(and you) can choose freely to participate or not to participate. In addition, at any point
during this project, you can withdraw your permission, and your child can stop
participating without any penalty of loss of benefits. I recognize that I am the researcher
in this project and, at the same time, your child's teacher. Thus, I will ensure that your
child's participation or non-participation in my research project does not impact his/her
grades, or our teacher-to-student relationship at Hoku High School.

Questions: If you have any questions about this project, please contact me, Kainoa
Wiley, via phone (808)777-1111 or e-mail (student@hawaii.edu). You can also contact
my advisor at the University of Hawaii, Dr. Advisor, at (808)777-2222 or via e-mail at
advisor@hawaii.edu. If you have any questions about your rights, or the rights of your
child as a research participant, you can contact the University of Hawai‘i, Human Studies
Program, by phone at (808) 956-5007 or by e-mail at uhirb@hawaii.edu.

            Please keep the prior portion of this consent form for your records.
    If you consent for your child to participate in this project, please sign the following
                signature portion of this consent form and return it to ***.

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                                             Tear or cut here
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Signature(s) for Consent:

I give permission for my child to participate in the research project entitled, 9th-Graders'
Perspectives on Using the World Wide Web to do Schoolwork.” I understand that, in
order to participate in this project, my child must also agree to participate. I understand
that my child and/or I can change our minds about participation, at any time, by notifying
the researcher of our decision to end participation in this project.


Name of Child (Print): ___________________________________________________


Name of Parent/Guardian (Print): _________________________________________


Parent/Guardian's Signature: _____________________________________________


Date: ____________________________




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