Incentive Receipt (English/Spanish)

A TTACHMENT 12A13A. Participant Receipt - English

The Trinity Study

Participant Receipt

This form serves as documentation of receipt of compensation for time and travel expenses by individuals participating in this research study.

(Print name)

I, ______________________________, have received the amount of $50 for my participation
in the Trinity Study.

(Date)

(Participant’s signature)

________________________________________ __________________

A ttachment 12B 13B – Participant Receipt - Spanish

El Estudio de Trinity

El recibo para participantes

Este _____ sirve come documentación de recibo del la _______ por gastos de tiempo y de viaje para individuals que participant en este studio de investigación.

This form serves as documentation of receipt of compensation for time and travel expenses by individuals participating in this research study.

(Nombre)

Yo, ______________________________, han recibido la cantidad de $50 para mi participación
en el Estudio de Trinity.

(Fecha de hoy)

(Firma de particpante)

________________________________________ __________________