Get Consent Form Action Research

Consent Form for Participation in an Action Research Project Research Project Online learning in a mentored Face-to-Face educational environment. Location Kensington Middle School Dates July 2001 to June 2002 Principal Investigator- Joe Herz Introduction Thank you for agreeing to help with this research. The purpose of this study is to evaluate the effectiveness of on-site face-to-face peer mentoring combined with independent on-line learning as a method to increase teacher understanding of and implementation of technology to assist in the delivery of curriculum* Benefits The most substantial benefits of the research are those gains made by the participants in better understanding how to use new hardware and software technology tools and in the use of technology within their curriculum* Risks Inconveniences Discomforts There are no risks associated with this study. Your responses are completely anonymous and the questions themselves are not personally probing ones. Cost of Participation The only cost to you is the time you take to participate. I am asking you to take 60-90 minutes out of your lengthy involvement in the technology cadre so there is a minor inconvenience involved* Confidentiality of Records I will treat your identity with professional standards of confidentiality. The information we obtain will be analyzed statistically and general findings will likely be published in scientific journals but individual participants identities will not be known* Withdrawal Participation is voluntary. We will answer any questions you may have about the study. You are free to withdraw your consent and discontinue participation at any time. If you decide to withdraw from this study you will still receive any credit for participating that was promised you. Contact Information Faculty Sponsors Bruce McVicker and/or Mike Menchaca CSUS IMET Internet Masters in Educational Technology. Participant s Rights If you have any questions concerning your rights as a research subject you may contact the Committee on the Conduct of Human Research at 828-0868 for information or assistance. Consent Statement I have read the above statement understand the nature of my participation in the research and I freely agree to participate. I recognize my right to withdraw my consent and discontinue participation in the project without fear of any prejudice and recognize that my activities and data generated by my participation will remain strictly confidential* I also understand that at the conclusion of the study I can choose to destroy any records of my participation and that if I desire I can request a copy of the final report describing the research s conclusions. Location Kensington Middle School Dates July 2001 to June 2002 Principal Investigator- Joe Herz Introduction Thank you for agreeing to help with this research. The purpose of this study is to evaluate the effectiveness of on-site face-to-face peer mentoring combined with independent on-line learning as a method to increase teacher understanding of and implementation of technology to assist in the delivery of curriculum* Benefits The most substantial benefits of the research are those gains made by the participants in better understanding how to use new hardware and software technology tools and in the use of technology within their curriculum* Risks Inconveniences Discomforts There are no risks associated with this study.