Human Subjects Guidelines / Page 1

Consent Form for:

ITEC 4310 Research for a Room Reservation System for the GGC LibraryGGC Students

You are being asked to be a volunteer in a research study

I am being asked to take part in a research study titled “Testing Prototype for a New Room Reservation System for the GGC Library”, which is being conducted by students enrolled in ITEC 4310 and Jim Rowan. I do not have to take part in this study; I can stop taking part at any time without giving any reason, and without penalty. I can ask to have information related to me removed from the research records or destroyed.

1: REASON/PURPOSE

The purpose of the study is to test a low-fidelity prototype of a system to be used to reserve study rooms in the GGC library. This study will determine the effectiveness of this particular system of room reservation, as well as test the usability of the system.

2: COMPENSATION AND BENEFITS

There is no compensation or extra-credit for participants. There is no immediate benefit to volunteers; however, this is an opportunity to voice input on a potential design for a potential future system.

3: PROCEDURES

  • Testing prototype: I will be asked to participate in a trial run of the system. This trial run would simulate situations to reserve a study room in the library.
  • Interview: Following the testing, I will be asked to participate in an interview. This interview will be a medium to provide input of the prototype testing.

When reporting this information, names will not be associated with the grades. Instead, a unique ID will be provided for each student. Any audio recordings collected will be destroyed after the study is completed.

4: DISCOMFORTS, STRESSES or RISKS

No risks are expected.

5: CONFIDENTIALITY

All information concerning me will be kept confidential: My instructor will not know whether I have agreed to participate in this study or not. My instructor will not be able to associate my responses with my name. My identity will be coded, and all data will be kept in a secured, limited access location. If information about me is published, it will be written in a way that I cannot be recognized. However, research records may be obtained by court order.

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Human Subjects Guidelines / Page 1

6: FINAL AGREEMENT & CONSENT FORM COPY

Minors should not participate in this study. By signing below, I certify that I am 18 years or older. I understand the procedures described above. My questions have been answered to my satisfaction. I have been given a copy of this form.

Please check one of the following:

_____ Yes, I agree to allow my data to be used for this research study.

_____ No, I do not give permission for my data to be used for this research study.

Please check one of the following:

_____ Yes, I am willing to be interviewed about my experiences with the Room Reservation Prototype.

_____ No, I do not want to be interviewed about my experiences with the Room Reservation Prototype.

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______
Signature of Participant. Date

______
Printed Name of Participant

______
Signature of Researcher. Date

For questions or problems about your rights please call, write, or email Dr. Juliana Lancaster: (678-466-4979); Chair, Institutional Review Board,1000 University Center Lane, Lawrenceville GA 30043;
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Human Subjects Guidelines / Page 1