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Elementary School - Pre

Assent form

Assent from Child (GPS Study)

Investigator: Hello, my name is Giacomo Bono. I’m a professor at California State University Dominguez Hills, doing a research study of a program your school is doing.

Purpose and Description of the Study:  We are asking you to participate in lessons to learn about how skills related to goals and social life may influence your life.  We will ask you to complete activities with your class and take surveys 3 times to learn if these activities are helpful for you. You will complete 4 lessons and complete surveys during school hours 3 times before and after the lessons. You may get optional homework. Surveys will take about 40 minutes each, and you can skip questions or stop taking the survey anytime if it makes you feel uncomfortable. Your teacher will be there if you have questions.

Risks or Discomforts:  We think you will enjoy participating in this project, but some kids may feel uncomfortable participating in the lessons or answering the survey. You can always skip anything that feels uncomfortable.

Confidentiality: When you take the surveys, you won’t have to put your name on them.  This means that your answers will NOT be connected with your name. No one at your school will ever see your answers.

Voluntary Nature of Participation:  Your mother, father or guardian has said it is OK for you to participate, but it is still up to you if you want to participate or not. No one will be upset with you or give you a bad grade if you do not participate. And you can change your mind and stop any time.

Will I get anything for participating? Your teacher and I want you to have fun with the lessons. So your teacher will have small rewards for doing a good job on the lessons or participating in the activities.

Questions about the Study:  If you have any questions, feel free to ask your teacher or parent(s) before making a decision - if that is more comfortable.






 
1. Please mark one of the choices below to tell us what you want to do:
Please enter the unique Student Code that was created for you to use during this project. If you are unsure what your code is, please check with your teacher.
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