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Students With Disabilities As Diverse Learners

REPLICATION STUDY AGREEMENT FORM: RECRUITER

Purpose of the Replication Study

Students with Disabilities as Diverse Learners (SDDL) projectstaff are facilitating Professional Development (PD) Replication training and research to improve retention and matriculation rates (i.e., completion of a class and graduation) of students with disabilities (SWD) in postsecondary education. PD will be conducted on three topic areas: 1) Universal Design for Learning (UDL), 2) Multiculturalism, and 3) Mentoring. The hypothesis is that by receiving the PD, faculty will 1) improve their knowledge, skills, and attitudes toward SWD; 2) implement pedagogical knowledge and skills acquired from the PD in their classes; and 3) contribute to increasing the retention and matriculation rates of SWD in their classes.

Faculty Roles

Recruiters will:

  1. Participate in a specialized replication webinar focusing on the content of the Professional Development (PD) modules to be replicated (planned to be held in August 2011)

2. Fill out all appropriate surveys.

3. Provide links to online surveys and suggest ways to get participants to fill them out.

  1. Provide links to online modules for anyone facilitating a PD training and remind them that they should do the trainings themselves and fill out appropriate surveys before they train others.
  1. Provide requested data about those recruited for the PD trainings.
  1. Provide data at Recruiter’s Institution of Higher Education including number of SWD enrolled; retention and graduation rates of SWD.

7. Recruit from 1 to 5 people (for compensation) to participate in the study. Participants must

be faculty or instructors who are currently teaching at a postsecondary institution. Participants must sign and return the attached Faculty Consent Form prior to participating in the study.

  1. Notify SDDL Staff if in need of technical support

Compensation:

You will be compensated in the amount of $100 for each study participant (up to 5 participants) ONLY after a participant has completed the training and all of the surveys.

Note: Compensation issubject to Federal and State income taxes.

Participation and Withdrawal

Your participation is voluntary, and you can end your participation at any time. Should you decide to withdraw from the study early, your financial compensation will be pro-rated based upon the length of time you were involved and the degree to which you were involved in the study. You are not waiving any legal claims, rights, or remedies because of your participation in this research study.

Identification of Investigators

If you have any questions, please contact:

Robert Stodden, Principal Investigator

Center on Disability Studies

University of Hawaii at Manoa

1776 University Ave. UA4-6

Honolulu, HI 96822

(808) 956-9199 OR

Steven E. Brown, Project Coordinator

Center on Disability Studies

University of Hawaii at Manoa

1776 University Ave. UA4-6

Honolulu, HI 96822

(808) 956-0996

(If you cannot obtain satisfactory answers to your questions or have comments or complaints about your treatment in this study, contact: Committee on Human Studies, University of Hawai`i, 1960 East-West Road, B-104, HI 96822. Phone: (808) 956-5007. E-mail: .)

Students With Disabilities As Diverse Learners

Recruiter Agreement to Participate

I certify that I have read and that I understand the information in this document. I certify that I have been given satisfactory answers to my inquiries concerning project procedures and other matters. I certify that participation is voluntary and I have been advised that I am free to withdraw my consent and to discontinue my participation in the project at any time without prejudice. I consent to participate in this project with the understanding that such consent does not waive any of my legal rights, nor does it release the Project Director or the institution or any employee or agent thereof from liability for negligence.

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Students With Disabilities As Diverse Learners

Recruiter Agreement to Participate

I certify that I have read and that I understand the information in this document. I certify that I have been given satisfactory answers to my inquiries concerning project procedures and other matters. I certify that participation is voluntary and I have been advised that I am free to withdraw my consent and to discontinue my participation in the project at any time without prejudice. I consent to participate in this project with the understanding that such consent does not waive any of my legal rights, nor does it release the Project Director or the institution or any employee or agent thereof from liability for negligence.

Signature

Please Print Your Name

Date

COPY TO PROJECT