Student Consent Form printable pdf download

Student Consent Form

Student: Assent Form

Title of the Study: The Thriving Classroom: Strengths-Based Professional

Development for Educators

Sponsor:

Mayerson Academy

Principal Investigator:

Mark Linkins

Email Address:

Telephone:

(610) 259-8699 (24 Hours)

Additional Contact:

Mary Judd

Address:

Bethlehem Central Middle School

332 Kenwood Rd.

Delmar, NY 12054

You are invited to participate in a research study. After reading this form, you can

decide to be in the study or you can decide not to be in the study. Either choice

is OK. If you decide to start the study and then change your mind, you can stop

being in the study at any time.

Please ask the principal investigator or study staff to explain anything you do not

understand. They will answer all the questions you have. You can ask questions

about the study at any time.

If you want to talk to the investigator alone please ask.

DESCRIPTION OF THE RESEARCH

The purpose of the study is to look at the results of the middle school’s focus on

character strengths. The research study is trying to help answer the following

question:

Does the school’s focus on character strengths help students to understand and

effectively use their own strengths?

Participation in the study is open to Bethlehem Middle School students and staff

members.

Mark Linkins

Chesapeake IRB Approved Version 11 Feb 2014

Student Consent Form