Various Pretesting Activities (see attached list)

Assent Form

Thoughts about Online Activities

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______________________ agree to take part in a study to find out more about how kids and teens think about online activities. I also agree to having the interview session 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 participation is voluntary and anything we you talk about 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 participate in this Census Bureau study, and I give my permission for my tape to be used for the purposes stated above.

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Minor’s Signature Researcher's Signature

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Printed Name Printed Name Printed Name Printed Name

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