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Participant Consent Form or Child Assent Form Participation in a Research Project South Dakota State University Brookings, SD 57007 Department of Sociology
Project Director Austin Kreutner and Halley Anderson Phone No. 605-688-4132 E-mail: [email protected] Date 10/6/15 Please read (listen to) the following information: 1. This is an invitation for you as a student to participate in a research project under the direction of Jacob Jantzer.
2. The project is entitled to study how employment status affects current place of residence in terms of gender and years of schooling attended.
3. The purpose of the project is to study the affects of the two variables.
4. If you consent to participate, you will be involved in the following process which will take about 10 minutes of your time: Surveys/questionnaires will take place in and around the campus area.
5. Participation in this project is voluntary. You have the right to withdraw at any time without penalty (will not affect your grades). If you have any questions, you may contact the project director at the number listed above.
6. There are no known risks to your participation in the study.
7. There are no direct benefits
8. There is no compensation money, extra credit, etc. for your participation in this study. We as the study group will find participants and will travel to accompany their needs.
9. Your responses are strictly confidential. When the data and analysis are presented, you will not be linked to the data by your name, title or any other identifying item. As a research participant, I have read the above, have had any questions answered, and agree to participate in the research project. I will receive a copy of this form for my information. If you have any questions regarding this study you may contact the Project Director. If you have questions regarding your rights as a participant, you can contact the SDSU Research Compliance Coordinator at (605) 688-6975 or [email protected].
You can also contact Austin Kreutner at [email protected], Halley Anderson at [email protected] or Jacob Jantzer at [email protected] if you have an further questions.
SDSU IRB approval number: IRB-1510001-EXM
 
 
 
 
How many years have you lived at your current residence while attending South Dakota State University?
   
 
 
 
Is the home you live in:
 
Family owned housing
 
Personally owned housing
 
Off campus rented housing
 
On campus housing
 
 
 
How is your housing paid for?
 
I personally pay
 
Student loans/grants
 
Scholarships
 
Parents/guardians
 
Other
 
 
 
 
Which of the following best describes your current primary employment situation? 
 
Employed full-time
 
Employed part-time
 
Unemployed, seeking employment
 
Unemployed, not seeking employment
 
Self-employment
 
Working for no wage (Farming, caregivers, family business)
 
Other
 
 
 
 
If you have a job, how far do you drive to work one way each day?
 
Less than 5 miles
 
6 to 10
 
11 to 25
 
Over 26
 
 
 
What is your sex?
 
Male
 
Female
 
 
 
Based on accumulated credits, what is your current level of schooling?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
 
 
After taking this survey please email: [email protected] within this email please include this password: sdsujacks verifying you have completed our survey in order to receive credit for SONA.
   
 
 
 
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After taking this survey please email: [email protected] within this email please include this phrase: sdsujacks verifying you have completed our survey in order to receive credit for SONA.