Consent Form

NASA TV Informed Consent Document.doc

NASA TV Viewers Survey

Consent Form

OMB: 2700-0126

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NASA-TV Informed Consent Document


NASA would like your perspectives about NASA-TV:

  • How do you use it?

  • Where do you access it?

  • How might NASA improve this service?


To collect this information, the NASA-sponsored Classroom of the Future at the Center for Educational Technologies® at Wheeling Jesuit University’s in Wheeling, WV, is conducting an online research survey. Participation is completely voluntary, and we do hope you will be able to share your perspective with us. Because we know your time is valuable, we’ve made the survey short. It contains only 17 questions, and completing it will take you less than 10 minutes. The survey will ask you multiple choice and open-response questions. You will select or type your responses into the online form.


There are no risks to you connected with your participation in this survey. The survey system will not ask you for or track personally identifiable information. It will not deposit any information on your computer.


If you have questions about the survey or the study, please contact Classroom of the Future™ researcher Dr. Debbie Denise Reese (304-243-4327 or [email protected]). This study has been approved by the Wheeling Jesuit University Institutional Review Board. If you have questions about the review board policy, you can contact the chair of the Institutional Review Board, Dr. Beverly Carter (304-243-2340 or [email protected]). This data collection has also been approved by the United States Office of Management and Budget (# ___________, valid through ____________).


By clicking the link to proceed to the survey, you are indicating your informed consent to participate in this study.


We value your contribution. Thank you for your time and insights.

File Typeapplication/msword
File TitleNASA TV Informed Consent Document
AuthorDebbie Denise Reese, Ph.D.
Last Modified ByWalter Kit
File Modified2007-01-25
File Created2007-01-25

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