2/3/2017

Dear Families,

As you may be aware, I am a graduate student in the Department of Early and Middle Grades Education
at West Chester University of Pennsylvania, in my last semester working toward my M.Ed. in Applied
Studies in Teaching and Learning. As part of my Masters degree program, I will be conducting a
classroom action research assignment to evaluate the benefits of self-assessment in the classroom.

I would like to include your child in my research project. I have discussed my research with my building
administrator.

During a period of 6-8 weeks, I will be integrating opportunities for self-assessment several times each
week. As students participate, I will be collecting data by not only evaluating assessment results, but also
recording observations about student participation, interviewing students, surveying students, and
interviewing fellow elementary teachers.

All data that I collect (observations, interviews, surveys, and test scores) will be kept confidential and no
references to students names will be used in my work at any time.

I do not anticipate any risk to students who participate greater than daily school life while conducting
my research. If you choose for your child to not participate they will still be included in our self-
assessment practices, however, I will not use information about them (observations/surveys/interviews/
test scores) in my research. The choice to participate or not will not impact you in any way. They will not
receive any additional benefits or any penalties for not being a participant in my research.

Additionally, you may withdraw your consent for your child to participate at any time, with no penalty.

All information that is obtained during this research project will be kept strictly secure. Your childs name
and any other information concerning your childs identity will be deleted from the research information.
Child and family confidentiality is most important and every effort will be made to insure that this
research remains confidential at all times.

The results of this study will be used for an online website that is required in my course, Teacher as a
Classroom Researcher, in the College of Education at WCU. Pseudonyms will be substituted for the
names of students included in my research. The website used to present my research is a password-
protected site, viewable by me, classmates, and my professor only.

Please indicate whether or not you consent to allow your child to participate in this research project by
returning the form below.

If you are willing to allow your childs participation, please return the attached form by
Wednesday, 2/8/17.

Sincerely,

Miss Lindsey Babczak

______________________________________________________________________________
I agree to for my child to participate in this research and I understand that observations, survey
responses, interviews, or test scores from my child will be included, anonymously. I understand there is
no risk to my child, and that I may withdraw my consent at any time, without penalty.

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Name Date