Eastern Mennonite University

Sample Text for Informed Consent Form

The purpose of this research is to identify and determine the primary factors that affect the quality of varsity intercollegiate athletic teams.

If you participate in this research, you will be asked to provide values statements, demographic, attitudinal, academic and athletic performance measures and information. There are no foreseeable risks or discomforts to you as the subject.

Your participation in the survey/interview will take approximately 20 minutes. The duration of this research project is May 1, 2006 – August 15, 2006.

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.

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. Results of the research will be reported as aggregate summary data only, and no individually identifiable information will be presented.

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 at the address below:

[Research name and address]

There will be no personal benefits to you from your participation in this research. However, the results of the research may contribute to an increase in the success of Division III intercollegiate athletic programs and the experience of the student-athletes involved.

I,_______________________, have read and understand the foregoing information explaining the purpose of this research and my rights and responsibilities as a subject. My signature below designates my consent to participate in this research, according to the terms and conditions listed above.

Signature _________________________
Date______________________________
Print Name ________________________