California State Polytechnic University, Pomona Informed Consent Form For Research Involving Human Subjects

California State Polytechnic University, Pomona Informed Consent Form for Research Involving Human Subjects
You are being invited to participate in a research study, which the Cal Poly Pomona Institutional Review Board (IRB) has reviewed and approved for conduct by the investigators named here. This form is designed to provide you - as a human subject - with information about this study. The Investigator or his/her representative will describe this study to you and answer any of your questions. You are entitled to an Experimental Research Subjects Bill of Rights and a copy of this form. If you have any questions about your rights as a subject, complaints about the informed consent process of this research study, or experience an adverse event (something goes wrong), please contact the Compliance Office within Cal Poly Pomonas Office of Research at (909) 869-4215. More information is available at the IRB website, www.csupomona.edu/research/irb.
Below is this header in Spanish: Forma de Consentimiento Informada para Investigacin que Implica Sujetos Humanos Usted est invitado a participar en un estudio de investigacin que el Comit Examinador Institucional (CEI) de Cal Poly Pomona ha revisado y aprobado para ser conducido por los investigadores nombrados aqu. Esta forma est diseada para proporcionarle informacin acerca de este estudio en su calidad de sujeto humano. El investigador o su representante le describirn este estudio y le contestarn cualquier pregunta que tenga. Usted tiene derecho a la Declaracin de Derechos del Sujeto que participe en una Investigacin Experimental y a recibir una copia de este documento. Si tiene alguna pregunta o quejas acerca del proceso descrito en dicho documento, por favor llame a la Oficina de la Conformidad que forma parte de la Oficina de Investigacin de la Universidad de Cal Poly Pomona al (909) 869-4215. Ms informacin esa disponible en sitio web de el CEI en el www.csupomona.edu/research/irb.
Title of IRB Protocol: Teachers Connect: Professional Development for Educators Protocol number as assigned by IRB: 13-078 Primary Investigator: Jessica L. Braun Telephone: 909-581-5484 Email: [email protected] Thesis Advisor: Dr. Teshia Roby Telephone: 909-869-4854 Email: [email protected]
This research study is affiliated with California State Polytechnic University, Pomona The study being conducted involves research of teacher opinion and feedback of the website Teachers Connect. The purpose of collecting teachers opinions about the professional development website Teachers Connect is to provide information to the researcher so that the website may be further developed in a way that best suits teachers.
You are being asked to view the website Teachers Connect, which is found at the website: www.teachersconnect.weebly.com and respond to an anonymous feedback survey. The feedback survey is located on the Connect with the Creator page of the Teachers Connect. The survey asks several questions about your experience, opinions, and feedback after viewing the website. The feedback survey you will complete was created through the website SurveyMonkey. You will not be asked for your name, or any identifiable information that would indicate who you are, or which responses you have given on the survey. Survey results are anonymous, and will ONLY be viewed by the researcher to identify areas of need or improvement for the Teachers Connect website. After reading this form you would like to participate in the Teachers Connect Feedback Survey, please click on the Feedback Survey button below. By clicking on the button, you are consenting to taking the survey, and that you approve of your responses being used anonymously in the researchers written thesis. All data will be drawn from participants who have consented to take the survey. If you do not wish to participate in the survey, do not click on Feedback Survey Button. . The expected duration of your participation in this study is between ten to twenty minutes. The study will take place between June 5, 2013 and June 6, 2013. There are minimal to no risks involved in participating in this study. Potential benefits of participation in this study include the introduction to a free website service ( Weebly), a free and useful survey website (SurveyMonkey), and access to new and useful multimedia tools that may benefit your individual or classroom curriculum. Any and all questions may be directed at Jessica Braun, primary investigator for the Teachers Connect study, or Dr. Teshia Roby, thesis advisor and Professor at Cal Poly Pomona. Jessica Braun: 909-581-5484 or [email protected] Dr. Teshia Roby: 909-869-4854 or [email protected] Participation in this study is completely voluntary. Non-participation in this study will not result in loss of benefits otherwise entitled to you. You may stop participation in this study at any time without penalty or loss of benefits.
To participate in Teachers Connect Feedback Survey, please consent by clicking on the Feedback Survey Button above. .

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