Appendix G3

PARENT CONSENT PREPAY+30 DOLLARS

OMB Control Number 1850-0882. Expires: 01/31/2015

On [DATE], I spoke with [TI NAME] on the telephone and agreed for my child and me to be in the
NLTS 2012.

This is a voluntary 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 18,000 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. In accordance to
federal law, 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 30-35 minutes. The questions were about our family,
experiences, and the support my child gets from school and other places. This interview was
recorded for quality control purposes. I will be interviewed again in 2014. I will be paid $5 before
and $30 after 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. This interview was recorded
for quality control purposes. 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.



If my child is about 16-18 years old in 2014, 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.
CONTINUES ON BACK →



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,
vocational rehabilitation agency services, or the Social Security Administration’s records about
jobs or benefits.



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.
o 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.
o 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.
o There are no special risks to my child if he or she takes part in 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.
o 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 the New
England IRB at 617-243-3924. 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.
o 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.1

1

This form will list only the items the parent consented to. Mathematica will track the components of the study that the
parent did not agree to.
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. Public reporting burden for this collection of information is estimated to average 30 minutes per principal response, 30-35 minutes per
parent, 30 minutes per each student, and 30 minutes per teacher for each of his or her selected students, and 30 additional minutes per each student aged 16-18
in 2014. This includes time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. The obligation to respond to this collection is voluntary. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to Yumiko Sekino at 555 New Jersey Ave NW, Washington DC, 20208
or email [email protected] reference OMB Control Number. Note: Please do not return the completed data forms to this address.