Faculty-Consent Forms

APPENDIX C.6.a

FACULTY CONSENT FORM

OFFICE OF RESEARCH INTEGRITY

TRAINING AND EDUCATION OF DOCTORAL STUDENTS INTERVIEW

During this interview, you will respond to a series of questions about the training and education of doctoral students. No direct benefits are expected from participation in this study other than the opportunity to discuss issues that may be of interest to you. The interview will not be shared with others except within the research team and the results will summarize key themes. Issues discussed in the interview may be discussed elsewhere as long as they are discussed in a way that does not identify participants or the institutions represented.

Please read the following statements and fill out the appropriate section.

1. Yes, I wish to participate in this study. I understand that my responses will be carefully protected so that others will not know what I say. The interview will be audio-recorded to facilitate analysis and reporting. The audio recordings will be kept by Mathematica Policy Research in a secure location for the length of the project. At the end of the project, they will be destroyed. Although the primary use of the recordings will be to inform the analysis for this research project, researchers may write articles based solely on the interviews. In that case, direct quotes from the recordings may be used to illustrate a point or illuminate findings, but any names or places that could be attributable to me personally will be omitted. I will be given $50 as a token of appreciation for participation in this research project.

I understand that I may choose not to answer specific questions asked during my interview by simply stating “Pass” or “I prefer not to answer.”

Faculty printed name

Faculty signature

2. No, I do not wish to participate in this study.

Faculty printed name

Faculty signature

Acording to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990- . The time required to complete this information collection is estimated to average ( hours)(minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 537-H, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

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