NSF Information Collection from Research & Related Activities Awardees

OMB Data Collection Number 3145-0215, expires June 30, 2020.

2018 Consent to Participate in NSF Telephone Interview

Name:

Award Title and ID:

Institution/Organization:

The National Science Foundation (NSF) is conducting a study on broadening participation (BP) of underrepresented groups in science, technology, engineering, and mathematics (STEM). An independent company, Windrose Vision, has been contracted to conduct the study. The study’s goal is to document how NSF projects that were not specifically funded as BP-Focused or BP-Emphasis may have successfully implemented BP activities. The study has been requested by the Evaluation and Assessment Capabilities section of NSF’s Office of Integrated Activities.

The phone interview is an opportunity to share your experiences and the accomplishments associated with the award titled [Award Title]. The information gathered will augment information compiled from the award’s Project Summary, Project Description, Annual Reports, and Program Outcomes Report.

PARTICIPATION AND WITHDRAWAL: You are under no obligation to participate in this interview, but your insights will be invaluable to the study. We strongly encourage you to consent. There are no consequences or risks for participating. Refusal to participate will have no impact on current NSF awards you may have or on your ability to obtain awards in the future. You may decline to answer any question and may discontinue the interview at any time.

AUDIO RECORDING: With your permission, your interview will be recorded to assist in the accurate presentation of your responses. Audio recordings will be protected on a secure server to prevent inappropriate use.

CONTACTS: For additional information about the NSF study, you may contact Dr. Nicholas Daly at NSF ([email protected]) or Dr. Madeleine Wallace at Windrose Vision ([email protected]).

Please sign your name below if you agree to participate in the phone interview.

Signature ___________________________________ Date _____________

Please indicate if you agree to an audio recording of your interview: I agree

I decline