SAMPLE SOCIAL SCIENCES EXPERIMENT CONSENT FORM (Used With Permission)

Western Oregon University and the Department of _____ support the practice of protecting research participants' rights. Accordingly, this project was reviewed and approved by the WOU Institutional Review Board. The information in this consent form is provided so that you can decide whether you wish to participate in our study. It is important that you understand that your participation is considered voluntary. This means that even if you agree to participate you are free to withdraw from the experiment at any time, without penalty.
This study is an investigation into some of the basic processes we use to understand text. For this study, you will complete two reading tasks: a) a sentence judgment task and b) a reading comprehension task. For the sentence judgment task you will be asked to judge whether sets of sentences are grammatical and your memory for some of the words in the sentences will be tested. For the reading comprehension task, you will read brief passages from a computer screen and answer some questions that test your understanding of the passages. In addition, you will be videotaped while you perform the task on the computer, so that we can observe you as you do the task. These videotapes will be viewed only by project personnel, who will transcribe them, and then the tapes will be placed in a locked file cabinet in my office until the following date: __________, when they will be destroyed. During this period only the principal investigator will have access to these tapes. This experiment poses no known risks to your health and your name will not be associated with the findings. For participation in this research project, you will receive $5 at the end of the session. Also, upon completion of your participation in this study you will be provided with a brief explanation of the question this study addresses. If you have any questions not addressed by this consent form, please do not hesitate to ask. You will receive a copy of this form, which you should keep for your records. We thank you for your time.

Researchers Signature (researchers name, office and phone number)

CONSENT STATEMENT: I have read the above comments and agree to participate in this experiment. I give my permission to be videotaped, under the terms outlined above. I understand that if I have any questions or concerns regarding this project I can contact the investigator at the above location or the WOU Institutional Review Board at (503) 838-8271

________________________________ _______________ (Participants signature) (date)