Form 1 - Student Research Consent Form - Memorial University Of Newfoundland Page 2

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FORM 1
If you sign this form, you do not give up your legal rights, and do not release the researchers from their
professional responsibilities.
Participants Signature:
I have read and understood the description provided; I have had an opportunity to ask questions and my
questions have been answered. I consent to participate in the research project, understanding that I
may withdraw my consent at any time. A copy of this Consent Form has been given to me for my
records.
I understand that I may withdraw my participation in this research at any time by contacting the student
researcher, and that any ethical concerns I have concerning the research (such as the way you have
been treated or your rights as a participant) which cannot be resolved by the student researcher may be
discussed with the course instructor,
(Name) ______________________ (Phone) _____________ (E-mail) ___________,
or the Head of the Department of Folklore, Memorial University of Newfoundland, St. John’s, NL,
A1B 3X8. Phone: 709-864-8402; E-mail: folklore@mun.ca.
________________________________________
__________________________
Signature of participant:
Date:
____________________________________________________________________________
Address:
Telephone number: ______________________
E-mail address: ______________________
Student Researcher’s Signature:
I have explained this study to the best of my ability. I invited questions and gave answers. I believe that the
participant fully understands what is involved in being in the study, any potential risks of the study and
that he or she has freely chosen to be in the study.
________________________________________
__________________________
Signature of student researcher:
Date:
____________________________________________________________________________
Address:
Telephone number: ______________________
E-mail address: ______________________
The project has been reviewed by the Department of Folklore’s Undergraduate Studies Committee and found
to be in compliance with Memorial University’s ethics policy.

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