Consent for Voluntary Participation

Dear Student,

I am taking a class at the University of Massachusetts that is part of my Masters of Education course work. Part of the course is to conduct research in my own class room. The content of my research plan is studying problem solving aptitude and confidence in our AP Physics B class during the fall semester of 2000. My results are intended for my growth as an educator . They will not be published and will only be used in the context of my graduate course.

In order to conduct this research I need your written consent. Your participation is voluntary and will have no impact on your grade or course work in AP Physics B. If at any time you decide you do not want to participate in the study, you are not obligated to continue. Please ask if you have any questions or concerns.

I, _______________________, volunteer to participate in this study and understand that:

1. My name will not be used at any time.

2. Sections of my class work and test questions may be shown to the other members of the graduate course anonymously.

3. Some sessions may be taped (audio or video) with the classes prior knowledge.

4. I have the right to review the final report before it is disclosed to the other members of the graduate course.

5. I may obtain a copy of the final report as desired.

Signed:_________________________________ Date:_____________________

Name Printed:___________________________

Sincerely,