Student Permission Form  
 

As part of my efforts to document the effectiveness of ED271, I am collecting student work (for example, reflections and final products) and other course materials. These materials are being used primarily to inform my own development of this and other courses. However, the results of this research, including examples of student work, may be published in some form (probably via the internet) for an audience of faculty members and others interested in school reform. With your permission, I would also like to include still images and, possibly, videotapes of our discussions in these presentations and products.


Your participation in this research is entirely voluntary. In order to ensure that your decision about whether or not to participate in this study will have no bearing on the evaluation of your work in the course, these forms will be collected by a student and mailed to me only after grades have been submitted. In addition, you have the right to withdraw your consent or discontinue your participation at any time without penalty. While your identity probably cannot be concealed in the videotapes, aliases will be used to refer to all other work.
The study has been designed so that it will not require any additional involvement beyond your participation in the course. I hope that my documentation and reflection on the progress of the course so far has enhanced your educational experience and will benefit students in future courses as well as faculty interested in documenting their own teaching.

I would sincerely appreciate it if you would review the attached form and indicate whether or not you would be willing to have your work used in this research.
Thanks a lot!

Thomas Hatch


Consent form for participation in research and documentation of ED271s

I agree to participate in the documentation and research of ED 271s being carried out by Thomas Hatch. I understand that materials that I produced as part of my participation in the course may be used in public products or presentations and that whenever possible aliases will be used when referring to this work.

____ Yes ____ No

I also agree to the use of still photographs and videotapes in these products and presentations with the understanding that it may not be possible to conceal my identity.

____ Yes ____ No

Signed

__________________________
(Signature)

___________________________
(Please print name)

_____________
(Date)

 
c. 2000, Thomas Hatch, Carnegie Foundation for the Advancement of Teaching.  All the material contained on this site has been produced by Thomas Hatch or other authors as noted. These materials can be downloaded, printed, and used with proper acknowledgement, including the name and affiliation of the author and the web-site address.