/2011-12%20Parental%20Consent_FIN

Consent to Participate in a Research Study Colorado State University Dear Parent or Guardian: Your son or daughter is currently involved in the EnvironMentors Program for the 2011-12 academic year.

EnvironMentors is a college access program for high school students who are interested in the environment and science. EnvironMentors is run out of a nonprofit organization called the National Council for Science and the Environment (NCSE).

NCSE and the EnvironMentors Program have teamed up with Colorado State University to better understand how the EnvironMentors Program benefits students who take part in the program. This research will include asking students about their experiences with EnvironMentors through a survey, a focus group, and tracking student discussion on an Online Community. NCSE, the EnvironMentors Program, and Colorado State University are asking your consent to allow your son or daughter to participate in this research.

Your son or daughter’s participation is completely voluntary. He or she may withdraw consent to participate at any time. Withdrawing consent will not change their status in the EnvironMentors Program, and will not affect nor their eligibility for program benefits such as a trip to Washington, DC, scholarship funding, or college access resources, to which they are otherwise entitled. The survey is also completely anonymous and will be held in strict confidentiality.

The results of this research will help us meet our mission: to provide a quality experience that strengthens students’ interests in science, the environment, and college. This will help us continue to improve the program for your son or daughter, and future EnvironMentors students.

If you consent to your son or daughter’s participation, they would complete a survey in October 2011 and a survey in May 2012. Each survey would take approximately 10 – 15 minutes to complete.

We hope the following material will provide you the information you need to provide consent for your son or daughter to participate in this survey. Please do not hesitate to contact your student’s Chapter Coordinator or me with any further questions or need for additional information. If you are satisfied with the information provided below, please sign and date the signature lines at the end of the document.

Thank you very much for your willingness to allow your son or daughter to participate in this research.

Sincerely,

Dr. Brett L. Bruyere Professor, Warner College of Natural Resources Colorado State University Page 1 of 4

TITLE OF STUDY: EnvironMentors Research PRINCIPAL INVESTIGATOR: Brett Bruyere,PhD brett.bruyere@colostate.edu WHY AM I BEING INVITED TO TAKE PART IN THIS RESEARCH? We would like you to participate in a research project to help us understand the most successful parts of the EnvironMentors program.

WHO IS DOING THE STUDY? Colorado State University, in partnership with the National Council for Science and Environment are conducting a study to assess the EnvironMentors program.

WHAT IS THE PURPOSE OF THIS STUDY? The purpose of the study is to determine if the program has an impact on your perceptions and attitudes about college, environmental issues and science. We also hope to understand what components of the program influenced those outcomes.

WHERE IS THE STUDY GOING TO TAKE PLACE AND HOW LONG WILL IT LAST? The study will include a survey at the beginning and end of the 2011-12 program. We will also review that materials and thoughts you post on your EnvironMentors community profile. If you are one of the students from your chapter that is selected to go to Washington DC for the annual EnvironMentors award ceremony, we will also ask that you participate in a discussion with us for about one hour on your thoughts about the program.

WHAT WILL I BE ASKED TO DO? You will be asked to complete a written survey that is approximately 30 questions and requires 10-15 minutes to complete. This survey will occur at the beginning and end of the program. Second, you will be asked to maintain your individual profile on the EnvironMentors community website. Lastly, if you are selected to go to Washington DC, we ask for your participation in a one-hour discussion.

ARE THERE REASONS WHY I SHOULD NOT TAKE PART IN THIS STUDY? No. If you need assistance in completing the survey, we can provide that help for you.

WHAT ARE THE POSSIBLE RISKS AND DISCOMFORTS? There are no risks to participating in this survey.

ARE THERE ANY BENEFITS FROM TAKING PART IN THIS STUDY? While there are no direct benefits for your participation in this survey, your input will help us continue to improve and enhance the EnvironMentors program.

DO I HAVE TO TAKE PART IN THE STUDY? Your participation in this research is voluntary. If you decide to participate in the study, you may withdraw your consent and stop participating at any time without penalty or loss of benefits to which you are otherwise entitled.

WHAT WILL IT COST ME TO PARTICIPATE? There are no costs to your involvement in this survey.

Page 2 of 4 Participant’s initials ______ Date ________

WHO WILL SEE THE INFORMATION THAT I GIVE? We will keep private all research records that identify you, to the extent allowed by law.

Your information will be combined with information from other people taking part in the study.

When we write about the study to share it with other researchers, we will write about the combined information we have gathered. You will not be identified in these written materials. We may publish the results of this study; however, we will keep you name and other identifying information private. We will make every effort to prevent anyone who is not on the research team from knowing that you gave us information, or what that information is.

For example, your name will be kept separate from your research records and these two things will be stored in different places under lock and key. You should know, however, that there are some circumstances in which we may have to show your information to other people.

CAN MY TAKING PART IN THE STUDY END EARLY? Unless you are no longer participating in the EnvironMentors program at the time of the post-test, there is no foreseeable reason for an early termination to your participation.

WILL I RECEIVE ANY COMPENSATION FOR TAKING PART IN THIS STUDY? You will receive incentives throughout the duration of the program for participation in this study. This will usually be $5-10 gift cards at a merchant near your school. You’ll receive 4-5 of these gift cards during the year as long as you continue to participate.

WHAT HAPPENS IF I AM INJURED BECAUSE OF THE RESEARCH? The Colorado Governmental Immunity Act determines and may limit Colorado State University's legal responsibility if an injury happens because of this study. Claims against the University must be filed within 180 days of the injury.

WHAT IF I HAVE QUESTIONS? Before you decide whether to accept this invitation to take part in the study, please ask any questions that might come to mind now. Later, if you have questions about the study, you can contact the investigator, Brett Bruyere at 970 491-6591. If you have any questions about your rights as a volunteer in this research, contact Janell Barker, Human Research Administrator at 970-491-1655. We will give you a copy of this consent form to take with you.

Your signature acknowledges that you have read the information stated and willingly sign this consent form.

Your signature also acknowledges that you have received, on the date signed, a copy of this document containing ____ pages. _________________________________________ Signature of agreeing to take part in the study

_____________________ Date

_______________________________ Printed name of person agreeing to take part in the study

_______________________________________ Name of person providing information to participant

_____________________ Date

_________________________________________ Signature of Research Staff Page 3 of 4 Participant’s initials _______

Date _______

PARENTAL SIGNATURE FOR MINOR

As parent or guardian I authorize _________________________ (print name) to become a participant for the described research. The nature and general purpose of the project have been satisfactorily explained to me by ______________________ and I am satisfied that proper precautions will be observed. __________________________________ Minor's date of birth __________________________________ Parent/Guardian name (printed) __________________________________ ___________________ Parent/Guardian signature Date

Page 4 of 4 Participant’s initials _______ Date _______