PISCE Consent Form

1850-NEW PISCE Attachment C - Consent Form.docx

Parent Information and School Choice Evaluation

PISCE Consent Form

OMB: 1850-0927

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Welcome to the Parent Information and School Choice Study


Thank you for agreeing to participate in the Parent Information and School Choice Study. This study is funded by the U.S. Department of Education’s National Center for Education Evaluation and Regional Assistance and is being conducting by Mathematica Policy Research, an independent research firm, with Survey Sampling International (SSI), Tembo, Inc., and researchers from Tulane University and Columbia University.


The purpose of this study is to help schools, districts and policymakers better understand how parents choose schools for their children. By completing this consent page, you are agreeing to complete a 40 minute web-based research study. The study will include questions about your experiences choosing schools. You will also be asked to complete an exercise where you review school information for a fictional city and make some decisions based on that information. Lastly, you will be asked to provide feedback about the information you reviewed. [FILL for in-person recruitment]: You will receive a $30 gift card to thank you for your participation upon completion of the questionnaire.


The survey should take approximately 40 minutes. You may save your work at the end of any section and return later. However, once you start a section, you must complete and submit it before saving. Also, you will not be able to move backwards in the survey to see or change earlier responses.


All information from this study will be kept confidential as required by the Education Sciences Reform Act of 2002 (Title I, Part E, Section 183). To ensure privacy, identification numbers will be used on the surveys rather than names. All of the information that is collected will be stored separately from school records in a secure location. Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific district, school, or individual. We will not provide information that identifies you, your school, or your district to anyone outside the study team, except as required by law.


Your participation is voluntary. There are no risks associated with participating in this study. Information we collect will be kept strictly confidential. If you have questions about the study, please contact Lisbeth Goble at XXXX or [email protected]. If you have questions about your rights as a research volunteer, please contact New England Institutional Review Board at toll-free 1-800-232-9570.

Shape1 if you are willing to participate in the study, please mark here





According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays an Office of Management and Budget (OMB) control number. The valid OMB control number for this information collection is xxxx-xxxx. The time required to complete this collection of information is estimated to average 40 minutes, including the time to review instructions, search existing data resources, gather the data needed and complete and review the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Meredith Bachman at 202-245-7494 or [email protected] and reference the OMB Control Number xxxx-xxxx.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLGoble
File Modified0000-00-00
File Created2021-01-24

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