Anda di halaman 1dari 1

Parent Permission Letter Date Dear Parent: We are from the Department of at the University of Illinois and we would

like to include your child, along with about 25 of his or her classmates, in a research project on . If your child takes part in this project, twice a week for three weeks, 15 minutes per day of your child's regular class will be spent learning about . Any children who do not participate will do other school work during this time. DESCRIBE THE ACTIVITIES DESCRIBE ANY RISKS Your child's participation in this project is completely voluntary. In addition to your permission, your child will also be asked if he or she would like to take part in this project. Only those children who have parental permission and who want to participate will do so, and any child may stop taking part at any time. You are free to withdraw your permission for your child's participation at any time and for any reason without penalty. These decisions will have no affect on your future relationship with the school or your childs status or grades there. The information that is obtained during this research project will be kept strictly confidential and will not become a part of your child's school record. Any sharing or publication of the research results will not identify any of the participants by name. In the space at the bottom of this letter, please indicate whether you do or do not want your child to participate in this project and return this note to your childs teacher before DATE. Please keep the second copy of this form for your records. We look forward to working with your child. We think that our research will be enjoyable for the children who participate and will help them to learn about . DESCRIBE THE BENEFITS If you have any questions about this project, please contact us using the information below. If you have any questions about your rights as a participant in research involving human subjects, please feel free to contact the University of Illinois Institutional Review Board (IRB) Office at 217.333.2670 or You are welcome to call these numbers collect if you identify yourself as a research participant. Please keep the attached copy of this letter for your records. Sincerely, (signature) Research Assistants Name Phone Number (signature) Professors Name Phone Number

****************************************************************************** I do/do not (circle one) give permission for my child (name of child) to participate in the research project described above. ___________________________________________ (Print) Parents name Parents signature ______________________ Date

Sample Parent Permission Letter

June 2007