Various Pretesting Activities (see attached list)

Consent Form

Thoughts about Online Activities

Each year the Census Bureau conducts many different surveys and research studies. The Census Bureau routinely tests questions and studies important concepts to produce the best information possible.

______________________[CHILD’S NAME] has my permission to take part in to take part in a study to find out more about how kids and teens think about online activities. In order to have a complete record of your child’s comments, the interview session will be audiotaped. We plan to use the tapes to help with our data analysis. Only staff directly involved in the research project will have access to the tapes. Your child’s participation is voluntary and your child’s answers will remain strictly confidential.

This study is being conducted under the authority of Title 13 USC, Section 8 . The OMB control number for this study is 0607-0725. This valid approval number legally certifies this information collection.

I have agreed to allow my child to participate in this Census Bureau study, and I give permission for his/her tapes to be used for the purposes stated above.

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Parent's Signature Researcher's Signature

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Printed Name Printed Name Printed Name Printed Name

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Date Date Printed Name Printed Name