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1. Ashford University, COE, Master of Arts in Education (MAED)
May 2014
Action Research
Informed Consent Form
Information
Course: EDU671 Fundamentals of Educational Research and EDU675: Change Leadership for the
Differentiated Educational Environment
Researcher Name: _Mary Lee Researcher Email:
__mlee6657@att.net/Mary.Lee@student.ashford.edu__________________
Researcher Phone: ____318518-5799______________
Location ofProposed Intervention/Innovation: ____Shreveport, Louisiana____________________________
This formserves two purposes;first,to acknowledge approval fromthe building principal or company supervisor for the
researcher to conduct the proposed action research and second, to informparticipants and/or parents/guardiansof minor
participants of the intentions of your study.
Student-researchers must submit this formif the proposed study involves any person(s) otherthan themselvesfor which a
planned intervention or innovation will occur. Students using this form within a school setting or other place of
employment must be a current employee at the site to seek permission to conduct action research at this location. A
separate formmust be provided to and signed by each parent or guardian of all minor (school-aged) children and/or
adult participant involved in the study. Each signed form will be reviewed by the student-researcher’s employer as
verification of participant acknowledgment.
Ashford instructors of EDU671 will store a back-up copy of this completed form in a secured drive, although it is the
student researcher’s responsibility to save, store, and submit to their instructors of both EDU671 and EDU675 as
required.
 Purpose: The purpose of this research is to [Is technology a distraction/ or an aid in better learning?Can
Technology prepare students to stay in school, active class participants, and learning to be fun and exciting?Does
Technology help motivate students to be active participants in class and eliminate school drop out? Do
Technology help enhance 21st century student center learning/
Many educators think technology will be an distraction instead of at tool for learning. The questions are design to
find research to demonstrate the true results. Technology in the 21stcentury is being used in everyday life many
students are digital natives the questions will explore to see is this a tool to help in academic gain address
learning styles, help students look forwards to school, and shift the roles of accountability from the teacher to the
student, and to help students become critical thinkers, decision makers, and problem solvers as they prepare for
future careers
Revised questions
How do we design learning task and activities, to balance student focus with technology
devices with contents, and contexts that is relevant to learning goals?
The focus is to design learning task and activities with technology devices to target
learning goals that will help keep student focus on learning and assignment
completion for academic gain and student achievement success.

2. Ashford University, COE, Master of Arts in Education (MAED)
May 2014
Participation: You will be asked to The parents were selectedin the study for interviews and surveys,
and permission consent forms signing, and any background on the student that is not in the
student’s records. The focus group were chose because I need to be able to bring this issue before
faculty and administrators to get the permission, and for professional help and to draw from the
experiences of colleagues. I also survey them to use data , and for technical support, so no one will
feel isolated. The students and teacher participants are the main focus participants because they
were the ones who presented the issue, Distraction of technology as a tool vs. a tool for learning.
These students who are digital natives that use some type of technology day by day, are important
in the research, they are the subjects of study, to observe. Through observation from instructors,
who are the researcher’s students reactions to technology devices can be perceived and took in
consideration, used as a data collected to compare, perceptions, reaction, reality, and
intervention? The perceptions are guidelines to direct on how to address the issue. The
background history is this is an alternative school program from all ethnic groups, cultures,
digital natives between 16 to 24 students that live on campus, and have faculty members who
monitor some of the activities they engage in every day. There are a more from low socio-
economic background, from single parent’s homes. The students have been placed in the facility
because they would not adhere to regular school programs therefore many have been placed
because of the court’s order them to enroll into some school. Students are not focus, and do not
like to take instructions, from any authorize person. Some are academically good, some or not.
Many are in identity crisis, trying to fit in to define who they
list what the participant is asked to do e.g. provide demographic information, be observed in the classroom setting, sharing
opinions and attitudes, or participating in measures of academic achievement.
Risks: There are no foreseeable risks to you as the subject.
Personal Benefits: There will be no personal benefits to you from your participation in this research. However, the
results of the research are intended to contribute to EDU671 Fundamentals of Educational Research and EDU675 Change
Leadership and Differentiated Instructional Environment class at Ashford University.
Time: Your participation in the action research study will take approximately [45 minutes per day for a month]. The
duration of this research project is [ Aug. 15, 2016 Sept. 15, 2016].
Voluntariness: Your participation in this research is strictly voluntary. You may refuse to participate at all, or choose to
stop your participation at any point in the research without fear of penalty or negative consequence.
Confidentiality: The information/data you provide for this research will be treated confidentially, and all raw data will be
kept in a secured file by the researcher. Personally identifiable information will not be shared.
Review of Research: You also have the right to review the results of the research if you wish to do so. A copy of the
results may be obtained by contacting the researcher: [Mary Lee 3185185799mlee6657@att.net]
Required Signatures Wendi Evans.

3. Ashford University, COE, Master of Arts in Education (MAED)
May 2014
Supervisor Consent
I, (print full name) _Mary Lee________________ have communicated with the researcher during the planning stages of
their proposed action research study and approve of their proposed study including the pending intervention/innovation to
be conducted during their enrollment in the subsequent course; EDU675. My signature as the supervisor indicates the
student conducting this proposed action research is an employee under my supervision. I further acknowledge receipt and
viewing of all signed and returned Informed Consent forms completed by participants and/or adults of minor children
participating in said action research intervention/innovation.
Name ofSupervisor (please print)____Wendi Evans___________________
Position/Title:______Teacher____________________ Phone:___3185190378_______________________
Email:________________________
Signature:_______WendiEvans_______________________________ Date:_July 23, 2016____________
Student-Researcher Acknowledgement
To be completed by the Ashford, MAED student
As the student-researcher of EDU671,I (your name) ___Mary Lee______________ acknowledge and accept my
responsibility to attain all signatures and submit the Informed Consent form to my instructor by Week Five of EDU671
and again during Week One of EDU675. I understand I will not move on to EDU675 and implement my proposed
intervention/innovation unless the Informed Consent form is completed and submitted on time.
Participant Consent
To be completed by the parent/guardian of minor participants and/or adult participants
I, (print full name) ___Students name not used nor parents__only chose students 18 and older___________________,
have read and understand the preceding information explaining the purpose of this research and my rights and
responsibilities as a subject and/or parent/guardian of a minor participant. My signature below designates my consent to
participate in this research,according to the terms and conditions listed above.
Participant/Parent/Guardian Signature:_________________________________ Date:________________
EDU671 Instructor Verification
I (EDU671 instructor name)____Mary Lee/ Tangela Salone_______________ verify that (student name)
__________________ successfully completed and submitted the required Informed Consent prior to the end of EDU671
and has passed the final project as well as the course,confirming readiness for EDU675 and subsequent action research
intervention/innovation.
Will give copies when needed.