Student Consent Form

Att_ELS Appendix C Informed Consents.doc

Adult ESL Explicit Literacy Impact Study (KI)

Student Consent Form

OMB: 1850-0811

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ADULT ESL LITERACY IMPACT STUDY

STUDENT CONSENT FORM


I agree to participate in the Adult ESL Literacy Impact Study.


I understand that:


  • The purpose of the study is to find out if instruction based on a new book is better at helping literacy students learn to read and speak English than the instruction usually used in my program’s literacy classes.


  • I will be placed in either a class that uses the new book or a class that does not use the new book, based on a random lottery process.


  • My participation in the study will last one term (either fall 2008 or winter/spring 2009).


  • I will be asked to participate in the following data collections:


  1. A short (30 minutes, maximum) literacy test in my native language during program intake (fall 2008 or winter/spring 2009);


  1. A short (30 minutes each, maximum) English literacy pre-test and brief interview within the first two weeks of class; and


  1. A longer English literacy test and an English speaking and listening test at the end of the term (60 minutes each, maximum).


  • I will be paid $50 after completing the tests given at the end of the term.


  • Study staff will also collect data from the program on my enrollment dates and attendance.


  • If I am randomly selected to attend the study class which uses the new book being studied, I will receive a free copy of the book. I may still have to purchase the program’s usual book for my class.


  • All information I give is confidential and will be used only for the study. My name will never be used in reporting the results of the study.


  • I will tell project staff if I move or change addresses.


  • Participation in the study is voluntary. If I have any questions about my participation, I may contact Larry Condelli, project director, at either [email protected] or 1-866-519-1884.


I understand the above and I agree to participate.


Name: ______________________________________________


Signature: ___________________________ Date: __________

ADULT ESL LITERACY IMPACT STUDY

TEACHER CONSENT FORM


I agree to participate in the Adult ESL Literacy Impact Study.


I understand that:


  • The purpose of the study is to evaluate whether a systematic literacy workbook (Sam and Pat) is effective in improving literacy-level adult ESL learners’ reading and speaking skills.


  • The study is commissioned by the U.S. Department of Education's Institute of Education Sciences. They will not be given my name for any reason.


  • The study will last from the summer of 2008 through the spring of 2009.


  • I will be assigned to teach a class that uses the Sam & Pat book or a class that does not use the Sam and Pat book, based on a random lottery process.


  • If I am assigned to teach a class that uses Sam & Pat, I will attend a three day training during the summer of 2008 on the use of Sam and Pat.. I will further attend a short (less than one day) webinar refresher training in January of 2009.


  • If I am assigned to teach a class that uses Sam & Pat, I will receive a copy of Sam and Pat before the fall 2008 term begins. If I am assigned to teach a class that does not use Sam & Pat, I will receive $40 in materials funds.


  • I will fill out the following forms or provide the following information as a part of participation in the study:


  1. Teacher Data Form (two times, summer 2008 and spring 2009)

  2. Daily student attendance in the study class


  • As a part of the study, I will be observed in my classroom three to five times during the study period.


  • All information I give is confidential and will be used only for the purpose of the study. The information that I provide will not be released in such a way that would enable someone to identify me.


  • Participation in the study is voluntary. If I have any questions about my participation, I may contact Larry Condelli, Project Director, at either [email protected] or 1-866-519-1884.


I understand the above and I agree to participate.


Name: ______________________________________________


Signature: ___________________________ Date: __________



File Typeapplication/msword
File TitlePARTICIPANT CONSENT FORM
AuthorJanuary Angeles
Last Modified Bykatrina.ingalls
File Modified2008-04-22
File Created2008-04-22

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