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Project Statement: Title of Survey

I invite you to participate in a web-based online survey that is anonymous. (Briefly describe the population to be surveyed) Your participation in this survey is very important to achieving this goal.

The survey is part of a research project to assess (briefly describe the nature and scope of your research).

The survey should take less than (keep it as short as possible) minutes to complete.

Participation in this research project is voluntary:

There are no direct benefits to you for participating in this research. There are no financial or reimbursement cost for you participation in this study.

The information will be used as part of a Master’s student thesis research project. The results will be published in the thesis. Participants may request a copy of the results by sending an email to the address below.

You may decline to participate in this survey or you may decline to answer certain questions. The web-based survey can be stopped at any time. There is no penalty or loss of benefits.

Your information will be kept confidential.

The web-based survey is administered through QuestionPro. QuestionPro does not collect or maintain any information that would identify who has taken the survey. Only the answers to the questions are recorded. There is no way for the researcher to know who answered which question. All questions are complied into a database for analysis. There are no questions in the survey that could lead to the identification of the individuals taking the survey. Any contact with the researcher must be made by the individual taking the survey, either by phone or email.







Statement of Risk:

There is no foreseeable risk other than the loss of the time to take this survey.

Questions about the research study or this survey:

You may contact the graduate student, (your name), directly by email (your email address) or the faculty thesis advisor (name and email address) or the Department of Emergency Management at Arkansas Tech University at 479-356-2159.

QUESTIONS REGARDING YOUR RIGHTS AS A RESEARCH SUBJECT
THESE MAY BE DIRECTED TO DR. MARY GUNTER – DEAN OF THE GRADUATE COLLEGE, ARKANSAS TECH UNIVERSITY COMMITTEE FOR THE PROTECTION OF HUMAN SUBJECTS (479-968-0398).

By proceeding past this point in the survey you are indicating that you consent to participation in this study. Please print out a copy of this consent form for your records.

Thank you for your time,
(your name)
 
 
 
 
What is your age?
 
18-20
 
21-24
 
25-30
 
30 and up
 
 
 
What is your gender?
 
male
 
female
 
 
 
What is your race?
 
white
 
black
 
hispanic
 
pacific islander
 
other
 
 
 
Which emergency do you think the military should be invovled with more?
 
terrorist attacks
 
natural disaters
 
riot
 
hazmat team
 
 
 
Are you currently enrolled in the military or interested in joining?
 
yes
 
no
 
 
How satisfied with the military role in emergency management are you?
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
 
 
 
 
What is your t number?
   
 
 
 
Please rank (1-5)how worried you are about the following? 5 being very worried
terrorist attack
natural disaster
 
 
How much authority do you feel the miltary should have in emergencys?
a lot of authority some authority very little authority
 
 
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