Documentation of Consent/Assent

OMB APPENDIX G. Consent and Assent Forms for Parent and Student Surveys

I agreed on the telephone for my child and me to be in the NLTS 2012 on [DATE]. This is a research study. Its full name is the National Longitudinal Transition Study 2012. The Department of Education is paying for this study. Mathematica Policy Research, Inc. is carrying out the study. He or she is one of 15,000 middle and high school students across the United States in the study.

The purpose of the research is to see what helps students move from school to adulthood. People who run schools hope that all students will leave school prepared for the future. Data from this study will be used to improve the ways schools help students become productive adults.

All information I give to the researchers or they find out from others or from records about me or my child will be completely confidential. Only researchers can see this information. Any data files used to write reports will be for researcher use only and will fulfill privacy regulations and guidelines set by the National Center for Education Statistics. It will not be shared with others. Information about me or my child will be combined with information from other students and parents in the study. My name or my child’s name will never be used. All reports will be written only in a summary form, and will not refer to any individual.

Being in the study means:

• An interviewer talked to me for about 40 minutes. The questions were about our family, experiences, and the support my child gets from school and other places. I will be interviewed again in 2014. I will be paid $20 for each interview I do.

• An interviewer also asked my child questions on the telephone for about 30 minutes. They talked about my child, school, and my child’s plans for the future. An interviewer will talk to my child again in 2014. I can help my child answer questions or answer for him or her. My child will get a $10 gift card each time he or she does an interview.

• When my child is about 16 to 18 years old, I agree that he or she may take a special test called an academic assessment. This test is for the study and will not count towards any classes in school. If he or she is in school, the test will take place during school. If not, the researchers will make an appointment for my child to take the test outside of school. The test will take between 15-45 minutes.

• In 2014, the researchers will also look at my child’s school transcripts to see what courses he or she has taken.

• They will want to see how my child is doing in the future. They may want to combine data from the survey with other information such as data on college enrollment, financial aid for college, or the Social Security Administration’s records about jobs or benefits. If they need my child’s social security number, they will ask for it during the second interview in 2014. I can decide to give them then, or not.

• The researchers will learn more about my child’s school by asking the principal to do a web survey. If I agree, the researchers will also ask my child’s mathematics or language arts teacher to do a web survey to learn more about my child’s classes.

• If my child has an IEP and I agree, the researchers will ask the school staff member who knows the most about it to do two web surveys to learn about his or her IEP. One survey will be now and another will be two years from now.

• Even if I consent for my child to participate in this study, my child must agree also. When my child turns 18 or no longer has a legal guardian, he or she must consent for himself or herself.

• Being in this study will not benefit my child personally, but it will help the Department of Education plan better programs for youth as they leave high school.

• There are no special risks to my child if he or she takes part in this study. There is nothing experimental about this study. If my child or I feel uncomfortable answering any of the interview questions we can stop without penalty. If my child or I change our minds about participating in the study, there will be no penalties for us.

• My child or I can ask questions or drop out of the study at any time by calling Anne Ciemnecki at Mathematica. Her number is 866-764-7962. There is no charge for this call. If I have any questions about my child’s or my rights as a research volunteer, I can call Melissia Billarrial at Public/Private Ventures. Her number is 1-800-775-4778, Extension 4778. This is the Institutional Review Board. They looked at this study to make sure my child’s rights as a person in this study are protected.

• There may be another phase of this study in the future and my child may be asked to participate again after 2014. We can decide to participate again or not at that time.

[FILL INTERVIEWER NAME] explained this to me:

FILLS INTERVIEWER SIGNATURE (ELE)

FILLS DATE OF CONSENT

[FILL INTERVIEWER NAME] explained this to [STUDENT]:

FILLS INTERVIEWER SIGNATURE (ELE)

FILLS DATE OF CONSENT

M y parents and I agreed on the telephone to be in the NLTS 2012 on [DATE]. This is a research study. Its full name is the National Longitudinal Transition Study 2012. The Department of Education is paying for this study. Mathematica Policy Research, Inc. is carrying it out. I am one of 15,000 middle and high school students across the United States in the study.

The purpose of the research is to see what helps students move from school to adulthood. People who run schools hope that all students will leave school prepared for the future. Data from this study will be used to improve the ways schools help students become productive adults.

All the information I give the researchers or they find out from others or from records will be completely confidential. It will not be shared with anyone in my school or home. Only researchers can see my information. Any data files used to write reports will be for researcher use only and will fulfill privacy regulations and guidelines set by the National Center for Education Statistics. Information about me will be combined with information about other students in the study. My name will never be used. All reports will be written only in a summary form, and will not refer to any individual.

Being in the study means:

• An interviewer asked me questions on the telephone for about ½ hour. We talked about me, school, and my plans for the future. An interviewer will talk to me again in 2014. My parent or guardian can help me answer questions or answer for me. I will get a $10 gift card each time I do an interview.

• The interviewer also talked to my parent or legal guardian for about 40 minutes. The questions were about my family, experiences, and supports I get from school and other places. They will be interviewed again in 2014. They will be paid $20 for each interview they do.

• When I am around 16 to 18 years old, I agree to take a special test called an academic assessment. This test is for the study and will not count towards any of my classes in school. If I am in school, the test will take place during school. If not, the researchers will make an appointment for me to take the test outside of school. The test will take between 15-45 minutes.

• The researchers will also look at my school transcripts to see what courses I have taken. They will do this in 2014.

• They will want to see how I am doing in the future. They may want to combine data from my survey with other information such as data on college enrollment, financial aid for college, or the Social Security Administration’s records about jobs or benefits. They may need my Social Security number to do this. If they do, they will ask for my Social Security number during the second interview in 2014. I can decide at that time if I want to tell them my Social Security number.

• The researchers will learn more about my school by asking my school principal to do a web survey. If I agree, the researchers will also ask my mathematics or language arts teacher to do a web survey to learn more about my classes.

• If I have an IEP and I agree, the researchers will ask the school staff member who knows the most about it to do two web surveys to learn about my IEP. One will be now and another will be two years from now.

• If I am not 18 years old yet, or if I have a legal guardian, my parent or legal guardian agreed for me to be in this study. Even if my parent or legal guardian agreed, I can decide whether I want to be in this study or not. When I turn 18 or no longer have a legal guardian, I must agree again, for myself.

• Being in this study will not benefit me personally, but it will help the Department of Education plan better programs for youth as they leave high school.

• There are no special risks to me if I take part in this study. There is nothing experimental about this study. If I feel uncomfortable answering any of the interview questions, I can stop and nothing bad will happen to me. If I change my mind, nothing bad will happen to me.

• I can ask questions or drop out of the study at any time by calling Anne Ciemnecki at Mathematica. Her number is 1-866-764-7962. There is no charge for this call. If I have any questions about my rights as a research volunteer, I can call Melissia Billarrial at Public/Private Ventures. Her number is 1-800-775-4778, extension 4482. This is the Institutional Review Board. They make sure my rights as a person in this study are protected.

• There may be another phase of this study in the future and I may be asked to participate again after 2014. I can decide to participate or not at that time.

[FILL INTERVIEWER NAME] explained this to me:

FILLS INTERVIEWER SIGNATURE (ELE)

FILLS DATE OF CONSENT

[FILL INTERVIEWER NAME] explained this to my parent or guardian [FILL NAME OF R FROM PARENT INTERVIEW]:

FILLS INTERVIEWER SIGNATURE (ELE)

FILLS DATE OF CONSENT

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