| Dear Student We would like to invite you to assist us in determining how best to promote youth development in schools. We are conducting a student survey about various areas of life (i.e. thoughts, feelings and behaviors in relation to school, family, friends, and ones self). This survey is anonymous meaning you will not be writing you name on the survey and no one in your school will know your answers. It is one class period long. This is voluntary and you will be able to skip any questions and stop at any time. Through this survey, you may become more aware of how you think/feel/behave in relation to your development and there are no significant risks involved. Our team comprises of two Malaysian PhD students in Human Development & Family Studies at The Pennsylvania State University. We welcome your feedback or interest in this survey. Please return the consent form below to our team members before taking the survey. Thank you. ------------------------------------------- Brendan J. Gomez & Ang Mei Mei Pennsylvania State University |
| For questions about this study contact: 1. The Principal address given above. 2. Brendan Gomez, Ang Mei-Mei, Mark Greenberg (PhD), The Research Team Mail: 402 Marion Place, Pennsylvania State University, University Park, PA16802, USA. Tel: 001-814-865-4123 (USA) Fax: 001-814-865-6004 (USA) E-mail: mcaw2002@yahoo.com 3. The Office for Research Protections, Pennsylvania State University. Tel: 001-814-865-1775 Email: ORProtections@psu.edu IRB# 15921 For personal or emotional advice/counseling/support contact: 1. Your School Counselor Tel: 2. The Befrienders Tel: 03-7956-8144/5 |
| Student Consent Form: A Study of Youth Development in Schools To : The Principal Student name: ___________________________________________ Class : ___________________________________________ (Please tick) I wish to participate in this survey. I do not want to participate in this survey. You will be taken to another room if you do not want to participate. ----------------------------------- ------------------------ Student signature Date |
| ORP USE ONLY: The Pennsylvania State University Office for Research Protections Approval Date: 6/27/03 J. Mathieu Expiration Date: 6/8/04 J. Mathieu Social Science Institutional Review Board |
| Information to Students & Consent Form |