TIF Informed Consent Form

INTERVIEW CONSENT FORM

Teacher Incentive Fund Evaluation

Purpose

You are invited to participate in a research project that aims to evaluate the Teacher Incentive Fund (TIF). This national evaluation is supported by the U.S. Department of Education and is being conducted by SRI International, Berkeley Policy Associates, and the Urban Institute.

The purpose of this study is to provide information to policymakers about the planning, implementation, and effects of the TIF program nationally. We are inviting you to participate in an interview based on your role in your school, district, charter management organization, State, or intermediary organization. Topic areas may include: the development and planning for your performance-pay system, the design and features of the system, and the performance-pay system’s successes and challenges.

Findings from the study will inform both national educational policy and local practice. Your participation is extremely valuable given the widespread interest in performance pay in education and hundreds of millions of dollars in local revenue and federal funds being expended. The information collected for this study can be used (1) by States, districts, and schools, in order to identify and develop policies to support promising practices performance-pay systems and, (2) the U.S. Department of Education to support refinement of current systems and new efforts to develop performance-pay systems.

Interviews will last on average 45 to 60 minutes (or not to exceed one class period for teachers). The questions we will ask are intended solely to provide information about the Teacher Incentive Fund and will not be used to evaluate any individual, school, or district.

Confidentiality

We will respect your confidentiality by not sharing your responses with anyone outside of the research team, except as required by law. The information that is collected for this study will be used only for research purposes and will not associate responses with a specific site or individual.

We would like your consent to record the interview. Recordings will be kept in a secure location by SRI International, Berkeley Policy Associates and the Urban Institute and will not be accessed by anyone outside of the research team, except as required by law. The audiotape will be destroyed at the conclusion of the study. You can participate in the interview but decline to have it recorded. Additionally, if you elect to have the interview recorded, you may stop the recording at any time.

Risks and Discomforts

Your participation in the interview is voluntary. You will not be penalized in any way for not participating in the interview. If you decide to participate, you may discontinue your participation in the interview at any time without penalty of any type. We do not foresee any risks or discomforts to you from participation in this study.

Benefits

Your participation in the interview will contribute to a more comprehensive understanding of the Teacher Incentive Fund and alternative teacher compensation programs.

More Information

If you have any questions, please ask and obtain answers before signing below. If you have questions later, please call Alix Gallagher, at 650-859-3504. Additional inquiries may be addressed to Human Subjects Committee, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, or 650-859-2686.

Informed Consent

By signing this form you are indicating that you have read and the above information, that your questions have been answered to your satisfaction, and that you have decided to participate based on the information provided.

After receiving the information provided above and answers to my questions, I agree to participate as a subject in the activity described. I understand that this is voluntary and is part of a study sponsored by the U.S. Department of Education and conducted by SRI International, Berkeley Policy Associates, and the Urban Institute.

I consent to the use and publication of any data or other information resulting from my participation, provided that I am not personally identified. I further understand that additional information regarding the study will be available to me on request and that I may withdraw my consent at any time.

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Signature of Interviewee Date

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Title Organization

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Signature of Interviewer Date

According to the Paperwork reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is (TBD). The time required to complete this information collection is estimated to average 45 to 60 or minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4537.