This consent form outlines the details of a research project taking place in Japan in 2014. It explains that the participant will receive information on the purpose and methods of the research, how their personal data will be protected, and any risks involved. It also notes that participation is voluntary, the participant's data will be kept confidential and destroyed at the end of the study, and they can withdraw at any time. By signing, the participant agrees to take part and provide the information requested.

1. Consent Form – Fieldwork Research Methods for Japan
On the Research Explanation, I have received a written explanation about the research project entitled
_____________________________________________________________________________________
from ___________________________________________________ on _____________________, 2014
at ________________________________. I understand the purpose of the research, how the research will
be conducted and the results released, and how my personal information will be managed and protected. I
agree to participate in this project, by providing the personal information requested of me.
Please tick the boxes to indicate that have received an explanation and understand that issue:
１ Research outline
□ the research purpose and research design, and how information will be collected
□ the method of releasing the results
□ what information the researcher would like me to provide
２ Methods of protecting personal information
□ it is necessary to gather personal information
□ this information will be appropriately stored and managed
３ Safety management
□ any possible mental impact and pain, or risks involved, will be minimized
４ Informed consent
□ Participation in this research is voluntary.
□ There is no problem if I do not participate in this research.
□ I will have the opportunity to discuss with the researcher what information I provide before
participating in the research project.
□ Only the information that I want kept will be kept.
□ I will be able to view my data if I want to.
□ Information that I share with the researcher will not be provided to a third party without my
permission.
□ I will able to withdraw my agreement to participate in this research project at any stage verbally
or in writing, even after agreeing to participate.
□ I will not be disadvantaged in any way by withdrawing from this research project.
□ My data will immediately be destroyed upon my withdrawal from this research project.
□ All of my personal data will be securely destroyed in December 2014 at the end of the Fieldwork
Research Methods course, except for the presentation, report and web-page.
Name: ____________________________________________ Signature: _____________________
[Student No.: ____________________________] Contact Phone No.: ______________________
Date: __________________________________