Consent Form

Attachment A. Informed Consent

Corps Members

Youth Leadership Development Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine youth leadership development in national service program. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in this project.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will be asked to complete a survey in one of two formats: online, or over the phone. You will be asked to complete the survey a total of three times over a two-year period. You will be asked to complete the first survey before you begin your service. You will complete the second survey at the end of the service with NCCC. You will complete the last survey one year after you complete your term of service with NCCC. The survey should take about 20 minutes to complete.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may be contacted by email or phone to complete follow-up surveys. You may skip any question, or take a break, or you may stop the survey or interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how youth in national service programs develop leadership qualities and skills.

Confidentiality and Privacy: We will protect all the information from the surveys and phone interviews, and keep them in a safe place. Only our researchers will have access to the information. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the survey are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences. You will receive a $20 gift card for completing the third service after you complete your term of service with NCCC.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree. [CLICK HERE to begin the survey].

• No, I do not agree.  STOP. Do not complete the survey.

Comparison Group

Youth Leadership Development Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine youth leadership development in national service program. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in this project.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will be asked to complete a survey in one of two formats: online, or over the phone. You will be asked to complete the survey a total of three times over a two year period. You will be asked to complete the first survey now. You will complete the second survey 10 to 12 months after you complete the first survey. You will complete the last survey one year after you complete the second survey. The survey should take about 20 minutes to complete.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may be contacted by email or phone to complete follow-up surveys. You may skip any question, or take a break, or you may stop the survey or interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how youth in national service programs develop leadership qualities and skills.

Confidentiality and Privacy: We will protect all the information from the surveys and phone interviews, and keep them in a safe place. Only our researchers will have access to the information. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the survey are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences. You will receive a $20 gift card for each survey you complete.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree. [CLICK HERE to begin the survey].

• No, I do not agree.  STOP. Do not complete the survey.

Corps Members - focus group and interview leadership development

Youth Leadership Development Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine youth leadership development in national service program. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in focus group or interview.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will participate in in one of two formats: focus group, or phone interview. You will be asked two times. The first time you will participate in a focus group before you complete your term of service with NCCC. The second time you will be contacted for a phone conversation to discuss your experience with NCCC. The focus group will take 90 minutes. The phone conversation will take 30 minutes.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may decide to skip any question, or take a break, or you may stop the interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how youth in national service programs develop leadership qualities and skills.

Confidentiality and Privacy: We will protect all the information from the focus group and phone interviews, and keep them in a safe place. The researchers will record the conversation, which will be used only for the purpose of the study. Your name will not be associated with any responses in the conversation. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the conversation are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree. [CONTRACTOR will contact you to provide information about the focus group]

• No, I do not agree.  STOP.

Sponsors/FEMA POCs focus group leadership development

Youth Leadership Development Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine youth leadership development in national service program. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in focus group or interview.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will participate in one of two formats: focus group, or phone interview. The focus group will take 90 minutes. The phone conversation will take 30 minutes.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may decide to skip any question, or take a break, or you may stop the interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how youth in national service programs develop leadership qualities and skills.

Confidentiality and Privacy: We will protect all the information from the focus group and phone interviews, and keep them in a safe place. The researchers will record the conversation, which will be used only for the purpose of the study. Your name will not be associated with any responses in the conversation. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the conversation are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree. [CONTRACTOR will contact you to provide information about the focus group]

• No, I do not agree.  STOP.

Corps Members/Team Leaders/Community Stakeholders – focus group and interview strengthening communities

Strengthening Communities Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine how to define community strengthening in the NCCC context and to measure these strengths in the community NCCC members serve. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in focus group or interview.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will participate in one of two formats: focus group, or phone of interview. You will only participate in only one of these formats. The focus group will take 90 minutes. The phone interview will take 30 minutes.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may decide to skip any question, or take a break, or you may stop the interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how to define community strengthening in the NCCC context and to measure these strengths in the community NCCC members serve.

Confidentiality and Privacy: We will protect all the information from the focus group and phone interviews, and keep them in a safe place. The researchers will record the conversation, which will be used only for the purpose of the study. Your name will not be associated with any responses in the conversation. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the conversation are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree.

• No, I do not agree.  STOP.

Sponsors/FEMA POCs – focus group and interview strengthening communities

Strengthening Communities Study

OMB Control Number: XXX (Expires XX/XX/XX)

You are invited to participate in a research study that will examine how to define community strengthening in the NCCC context and to measure these strengths in the community NCCC members serve. The study will be conducted by [NAME OF CONTRACTOR], a research organization, on behalf of the Corporation for National and Community Service. We are asking for your consent to participate in focus group or interview.

What activities will you do in the study and how long will the activities last? If you decide to participate in the study, you will be asked to participate in a phone interview two times. Each phone interview will take 30 minutes.

Benefits and Risks: We believe there is little or no risk to you in participating in this project. You may decide to skip any question, or take a break, or you may stop the interview. You may also withdraw from the project altogether. There may be no direct benefits to you for participating in this research project. The results of this project will contribute to knowledge about how to define community strengthening in the NCCC context and to measure these strengths in the community NCCC members serve.

Confidentiality and Privacy: We will protect all the information from the focus group and phone interviews, and keep them in a safe place. The researchers will record the conversation, which will be used only for the purpose of the study. Your name will not be associated with any responses in the conversation. Your responses will be combined with the responses of other participants. No identifying information about you will be shared when the results of the conversation are presented.

Voluntary Participation: Your participation in the study is voluntary and your responses will remain private to the extent permitted by law, as is provided for in the Privacy Act of 1974. You can choose freely to participate or not to participate. At any point during this project, you can stop participating without any adverse consequences.

Please indicate your agreement to participate in today’s study by signing below…

Printed Name: __________________________________

Signature: _____________________________________ Date: ____________________

Do you agree to participate in this study?

• Yes, I agree.

No, I do not agree.  STOP.