Rey Ty. Sample Consent Form for Academic Research Paper.

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Rey Ty. Sample Consent Form for Academic Research Paper.

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Rey Ty. Sample Consent Form for Academic Research Paper.

  1. 1. Consent Form ADULT (18 or older) I am aware that my participation is voluntary and that I am free to participate in the research project titled “Human Rights, Peace Education and Conflict Resolution: NGOs, Civil Society, Social Movements, and Social Transformation” being conducted by Reynaldo R. Ty, a Doctoral candidate at Northern Illinois University. I have been informed that the goal of this inquiry is to investigate the role, experiences, perceptions of and social issues that affect popular educators actively involved in civil society, non-governmental organizations, and social movements to bring about social change in order to construct a grounded model which will explain the phenomenon. I understand that if I agree to participate in this study, I will be asked to do the following: (1) take part in an hour-long one-on-one interview; and (2) share my writings or published articles about my volunteer social-work efforts that promote social change. I am aware that my participation is voluntary and that I am free to decide not to participate or to withdraw at any time without penalty or prejudice, and that if I have any additional questions concerning this study, I may contact Rey Ty at (area code) 753-xxx or Dr. xxx xxx at (area code) 753-xxx. I understand that if I wish further information regarding my rights as a research subject, I may contact the Office of Research Compliance at Northern Illinois University at (area code) 753-xxx. People, such as you, who are publicly known for your volunteer work in non-governmental organizations, are invited to take part in this research. As my volunteer work is public information, I decide to have all information gathered during this study to be made public, as I want to publicize all my voluntary social-action-related 1
  2. 2. activities that promote positive social change so that I can inspire more people to do volunteer work. I understand that there are no known risks or discomforts associated with this study. By participating in this research, I will benefit in the following ways: (1) to gain knowledge about the larger picture of the role of people in civil society engaged in social transformation work, (2) to have the opportunity to participate in a qualitative participatory action research study that produces a grounded theory, and (3) to have my name and my volunteer work, which are already publicly recognized, mentioned in the research papers. I understand that my consent to participate in this project does not constitute a waiver of any legal rights or redress I might have as a result of my participation, and I acknowledge that I have received a copy of this consent form. _____________________________________________________ _ _____________________ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date I give my consent to have my name appear in the research findings. _____________________________________________________ _ _____________________ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date I give my consent for the researcher to quote me in any papers or articles resulting from this interview. _____________________________________________________ _ _____________________ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date I give my consent to have my photographs appear in the research findings. The researcher can take my photos and I will provide photos to the researcher, if needed. _____________________________________________________ _____________________ 2
  3. 3. _ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date 3
  4. 4. I give my consent to have videos of me be taken and used in the research. The researcher can take videos of me and I will provide videos of me to the researcher, if needed. _____________________________________________________ _ _____________________ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date I give my consent for all the interviews to be tape-recorded. _____________________________________________________ _ _____________________ Signature of Participant (Type your name above as your digital signature if to be returned by email.) Date Rey Ty, xxx Hall #xxx, Northern Illinois University, DeKalb, IL 60115, (area code) 753-xxx, xxx@niu.edu; Dr. XXX XXX, Department of Counseling, Adult and Higher Education, Northern Illinois University, (area code) 753-xxx, xxx@niu.edu. . 4

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