[INSERT TITLE OF PROJECT]
LETTER OF INFORMATION
Introduction
My name is (**) and I am (status and title) at the Faculty of Education at Western University. I am currently conducting research into (*****give a simple topic, DO NOT explain why you are doing the research since your statement could sound like begging) and would like to invite you to participate in this study.
Purpose of the study
The aims of this study are (**give a brief summary but DO NOT make any claims about the potential value of the research).
If you agree to participate
If you agree to participate in this study you will be asked to … (***give a complete but brief description of what the potential participant will be asked to do, the location of the research and an estimate of the time required of subjects. Use the pronouns “you/your” throughout.).
Confidentiality
The information collected will be used for research purposes only, and neither your name nor information which could identify you will be used in any publication or presentation of the study results. All information collected for the study will be kept confidential. (***explain how subject confidentiality will be protected and what you will do with the data collected when you have finished the study.)
Risks & Benefits
There are no known risks to participating in this study (***or describe the potential risks). (Benefits need not be described especially if they are not direct benefits to the participants.)
Voluntary Participation
Participation in this study is voluntary. You may refuse to participate, refuse to answer any questions or withdraw from the study at any time (***with no effect on your academic status [or employment status]).
Questions
If you have any questions about the conduct of this study or your rights as a research participant you may contact the Office of Research Ethics, Western University at 519-661-3036 or . If you have any questions about this study, please contact (**give the name and telephone number [and email address] of the researcher and the faculty advisor if the applicant is a student).
This letter is yours to keep for future reference.
[Signature]
(*******Choose a version of the consent form as appropriate**************)
[Insert TITLE OF THE PROJECT]
[Insert Names and affiliations of researchers]
CONSENT FORM
I have read the Letter of Information, have had the nature of the study explained to me and I agree to participate. All questions have been answered to my satisfaction.
Name (please print):
Signature: Date:
[**********If applicable include:]
Name of Person Obtaining Informed Consent:
Signature of Person Obtaining Informed Consent:
Date:
[Insert TITLE OF THE PROJECT]
[Insert Names and affiliations of the researchers]
CONSENT FORM
I have read the Letter of Information, have had the nature of the study explained to me and I agree that my child may participate in the study. All questions have been answered to my satisfaction.
Name of child (please print):
Signature of Child:
Name of Parent/Guardian (please print):
Signature:Date:
[*******If applicable include:]
Name of Person Obtaining Informed Consent:
Signature of Person Obtaining Informed Consent:
Date:
[INSERT Title of Project]
[Insert Names and affiliations of Researchers]
CONSENT FORM
I have read the letter of information, have had the nature of the study explained to me and I agree that my child may participate in the study. All questions have been answered to my satisfaction.
______
Name of Student
______
Student's SignatureDate
______
Printed Name of Parent/Guardian
______
Parent/Guardian's SignatureDate
[*******If applicable include:]
Name of Person Obtaining Informed Consent:
Signature of Person Obtaining Informed Consent:
Date:
[******If applicable include:]
Name of Person Translating (or Reading) Document:
Signature of Person Translating (or Reading)Document:
Date: