Date: February, 2014

Project Title: Student Stories of Service-Learning !"eriences

Principal Investigator (PI): rin S#ar"e, P#$ Department of %ecreation and Leisure Studies Brock University (905) 688 5550 e!t" #989" $mail: es%arpe&'rock("ca &'(&T)T&*' )o( are invite* to participate in a st(*y t%at involves researc%" +%e p(rpose of t%is st(*y is to (n*erstan* t%e e!periences of (niversity st(*ents ,%o %ave 'een involve* in service learning" +,)T-S &'(*L( $ -s a participant. yo( ,ill 'e aske* to participate in an intervie, ,%ere yo( ,ill 'e aske* to s%are stories from a service learning e!perience t%at yo( %ave %a*" Participation ,ill take appro!imately .0-4/ 0inutes of yo(r time" I ,o(l* like to make an a(*io recor*ing of o(r *isc(ssion if t%is is accepta'le to yo(" If yo( *o not ,ant t%e intervie, to 'e a(*io recor*e*. I ,ill take ,ritten notes *(ring t%e intervie," P*T 'T&)L 1 ' F&TS )'$ %&S2S Possi'le 'enefits of participation incl(*e %elping to a*vance t%e state of kno,le*ge on st(*ent e!periences in service learning" +%ere are no kno,n or anticipate* risks associate* ,it% participation in t%is st(*y" 3*'F&$ 'T&)L&T4 +%e information yo( provi*e ,ill 'e kept confi*ential" )o(r name ,ill not appear in any report res(lting from t%is st(*y. nor ,ill 'e t%e name of t%e co(rse or program in ,%ic% yo( participate*" /o,ever. ,it% yo(r permission. anonymo(s 0(otations may 'e (se*" 1%ortly after t%e intervie, %as 'een complete*. I ,ill sen* yo( a copy of t%e transcript to give yo( an opport(nity to confirm t%e acc(racy of o(r conversation an* to a** or clarify any points t%at yo( ,is%" Data collecte* *(ring t%is st(*y ,ill 'e store* in a locke* file ca'inet in t%e office of t%e Principal Investigator. an* electronic files ,ill 'e store* on a pass,or* protecte* comp(ter" -(*io files ,ill 'e *estroye* as soon as t%ey are transcri'e* (appro!imately one mont% after t%e intervie,)" $lectronic files of t%e *ata ,ill 'e kept for t,o years. after ,%ic% time t%ey ,ill 'e *elete*" -ccess to t%is *ata ,ill 'e restricte* to t%e investigators an* researc% assistants for t%e pro2ect" -ll researc% assistants on t%e pro2ect ,ill 'e re0(ire* to sign a confi*entiality agreement" (*L5'T)%4 P)%T&3&P)T&*' Participation in t%is st(*y is vol(ntary" If yo( ,is%. yo( may *ecline to ans,er any 0(estions or participate in any component of t%e st(*y" 3(rt%er. yo( may *eci*e to ,it%*ra, from t%is st(*y at any time an* may *o so ,it%o(t any penalty an* yo( ,ill still receive t%e 450 gift car*" If yo( *eci*e to ,it%*ra,. t%e intervie, ,ill 'e terminate*" )o( ,ill 'e aske* if yo( ,o(l* like t%e information t%at yo( %ave s%are* (p to t%at point to 'e incl(*e* in t%e analysis or if yo( ,o(l* like t%e information to 'e *estroye*" P51L&3)T&*' *F % S5LTS

6es(lts of t%is st(*y may 'e p('lis%e* in professional 2o(rnals an* presente* at conferences" - s(mmary of t%e res(lts of t%is st(*y ,ill 'e availa'le from t%e st(*y a(t%ors in early 7055" 3*'T)3T &'F*%6)T&*' )'$ T,&3S 3L )%)'3 If yo( %ave any 0(estions a'o(t t%is st(*y or re0(ire f(rt%er information. please contact $rin 1%arpe (sing t%e contact information provi*e* a'ove" +%is st(*y %as 'een revie,e* an* receive* et%ics clearance t%ro(g% t%e 6esearc% $t%ics Boar* at Brock University 8file 95# 580:" If yo( %ave any comments or concerns a'o(t yo(r rig%ts as a researc% participant. please contact t%e 6esearc% $t%ics ;ffice at (905) 688 5550 $!t" #0#5. re'&'rock("ca" +%ank yo( for yo(r assistance in t%is pro2ect" Please keep a copy of t%is form for yo(r recor*s" 3*'S 'T F*%6 I agree to participate in t%is st(*y *escri'e* a'ove" I %ave ma*e t%is *ecision 'ase* on t%e information I %ave rea* in t%e Information <onsent =etter" I %ave %a* t%e opport(nity to receive any a**itional *etails I ,ante* a'o(t t%e st(*y an* (n*erstan* t%at I may ask 0(estions in t%e f(t(re" I (n*erstan* t%at I may ,it%*ra, t%is consent at any time" >ame: ?????????????????????????????????????????????????????????????????? 1ignat(re: ???????????????????????????????????????????????????? Date: ??????????????????????????? I agree to %ave my intervie, a(*io recor*e*: ?????? I ,o(l* like to receive a s(mmary of t%e st(*y fin*ings ,%en t%ey are availa'le: ??????