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Indiana University Northwest

Human Subjects Committee

IUN Exhibit B1

Below is a sample of Students as Subjects Information Sheet.

Given to Student at the Beginning of a Course
SAMPLE INFORMATION SHEET
Indiana University Northwest
Study Information Sheet

[Project Title]     Study # _____

You are invited to participate in a research study.  This study investigates ______________________.  It will be in conjunction with your course_____________ which I will teach this  ______________ .

INFORMATION
The following activities are part of the normal curriculum of [name of course].   [Describe activities, e.g. required writings, tests] 

At the end of the course, after grades have been submitted, I will ask for your written consent to review your class activities for the study described above.  I will also ask your consent to participate in an audio-taped interview regarding your experiences with this class.  The interview will be no more than ____ hour(s) in length.

BENEFITS
The benefits are: _____________. 

RISKS
There are no foreseeable risks in participating in this study.  No data will be analyzed until after grades are entered. 

CONFIDENTIALITY
The information in the study records will be kept confidential.  No reference will be made in oral or written reports that could link you to the study.  Access to the tapes of your interviews will be limited to research investigatorsand paid transcribers.  Typed transcripts of these tapes will be madeand in those typed transcripts pseudonyms will be used for all names of persons.  At the conclusion of the study (xx-xx-xx), these tapes will be ___________. 

CONTACT
If you have any questions about this study or its procedures, please contact ________________.

If you feel you have not been treated according to the descriptions in this form, or that your rights as a participant have not been honored during the course of this project, you may contact the Human Subjects Committee, Academic Affairs, Indiana University Northwest, Gary IN, 46408 980-6707 or by email at iunhsc@iun.edu.

PARTICIPATION
Your participation (allowing your class data to be used) in this study is voluntary .  Refusal to participate will involve no penalty.  If you decide to participate, you may withdraw from the study at any time without penalty.  If you withdraw from the study your data will be returned to you or destroyed.

Information Sheet date XX-XX-XX