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Informed Consent Agreement
Please read this consent agreement carefully before you decide to participate in the study.
Purpose of the research study: The purpose of this study is to examine the impact involvement with a program or community has on the student experience.
What you will do in the study: Participants will complete a survey regarding a particular aspect of their college experience.
Time required: The study will require about 15 minutes of your time.
Risks: There are no anticipated risks in this study.
Benefits: There are no direct benefits to you for participating in this research study. The study may help us understand the benefits of specific programs and communities to the undergraduate experience.
Confidentiality: The information that you give in the study will be anonymous. Your name or other identifying information will not be collected or linked to these data.
Voluntary participation: Your participation in the study is completely voluntary.
Right to withdraw from the study: You have the right to withdraw from the study at any time without penalty.
How to withdraw from the study: If you want to withdraw from the study, stop the survey and do not submit your responses. There is no penalty for withdrawing. Because data is anonymous it will not be possible to withdraw after your materials have been submitted.
Payment: You will receive no payment for participating in the study
If you have questions about the study, contact:
Christian L. Steinmetz, Ph.D.
Curry School of Education, EDLF – Higher Education
University of Virginia, Charlottesville, VA 22903.
Telephone: (434) 924-3180
Email address: [email protected]
If you have questions about your rights in the study, contact:
Tonya R. Moon, Ph.D.
Chair, Institutional Review Board for the Social and Behavioral Sciences
One Morton Dr Suite 500
University of Virginia, P.O. Box 800392
Charlottesville, VA 22908-0392
Telephone: (434) 924-5999
Email: [email protected]
Website: www.virginia.edu/vpr/irb/sbs
Agreement: Completion and submission of this survey indicates consent to participate. |
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| * What race or ethnicity do you identify with? Please choose as many options that apply to you. |
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| * What forms of government assistance have you or your family received within the past 12 months? Please choose all that apply to you. |
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| * Did you fill out the FAFSA or have someone fill it out on your behalf? |
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| * Did you receive the Pell Grant or were you eligible for the Pell Grant this school year? |
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* Please rank (1-6) the following reasons for attending UVa in order of importance:
1 = most important
6 = least important |
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| Extracurricular activities |
| | | Family influence |
| | | Location of college/university |
| | | Reputation of college/university |
| | | Financial aid package |
| | | Cost of attendance |
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| Which of the following factors were important to you in determining which college you ultimately attended? Please rate each option based on your feelings.
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| * Did you receive any of the following types of financial aid? Please select as many that apply to you. |
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| * Do you commute to school? |
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| * What is your current living situation? |
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| * How many colleges did you apply to? |
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| * How many colleges were you accepted to? |
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| * Are you currently attending your first choice college? |
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| * Did you attend another college or university before this one? |
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| * If you could do it again, would you still enroll at your current institution? |
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| * What is your enrollment status? |
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| * What is your academic year? |
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| * What is your intended major? | | |
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| * What is your mother's highest level of education? |
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| * What is your father's highest level of education? |
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| * What gender do you identify with? |
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| If you would like to be entered into the random drawing for the $25 or $75 VISA Gift Cards, please put your computing ID in the box below (ex. UVA2T). Your responses on this survey will not be associated with your computing ID. This ID will only be used to select and notify the recipients on the gift cards. | | |
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