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Informed-consent

This document is an informed consent form for a study examining the effects of peer rejection on the academic performance of Grade 12 STEM students at Negros Oriental High School. It outlines the purpose, procedures, benefits, confidentiality, and the voluntary nature of participation, emphasizing that participants can withdraw at any time without affecting their relationship with the school. The study aims to enhance understanding of peer dynamics to improve educational outcomes, and no payment will be provided to participants.

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9 views2 pages

Informed-consent

This document is an informed consent form for a study examining the effects of peer rejection on the academic performance of Grade 12 STEM students at Negros Oriental High School. It outlines the purpose, procedures, benefits, confidentiality, and the voluntary nature of participation, emphasizing that participants can withdraw at any time without affecting their relationship with the school. The study aims to enhance understanding of peer dynamics to improve educational outcomes, and no payment will be provided to participants.

Uploaded by

molinagary313
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SAMPLE INFORMED CONSENT

(THIS IS FOR ETHICAL CONSIDERATIONS)

The Effects of Peer Rejection on the Academic Performance of Grade 12 STEM


Students at Negros Oriental High School

INTRODUCTION
The College of Teacher Education of Negros Oriental State University, Main Campus 1
support the practice of protection for human subjects participating in any form of research. The
following information is provided for you to decide whether you wish to participate in the
present study. You may refuse to sign this form and not participate in this study. You should be
aware that even if you agree to participate, you are free to withdraw at any time. If you do
withdraw from this study, it will not affect your relationship with the aforementioned agencies.

PURPOSE OF THE STUDY


You are invited to allow your school to participate in a research study aimed at exploring
the effects of peer rejection on the academic performance of Grade 12 STEM students. The goal
is to gain insights into how peer dynamics influence educational outcomes and emotional well-
being among students.

PROCEDURES
You will be asked to answer the interview questions and during this process,
audio/video recordings will be taken as an additional tool for the collection of data. You have
the option of having taping stopped at any time. Video/Audio recordings will be transcribed by
the research committee headed by Craig N. Refugio. Rest assured that video/audio recordings
will be stored with utmost security and if and when necessary the recordings will be
erased/destroyed.

BENEFITS
Allowing this study in your school will contribute to a better understanding of peer
relationships and academic performance, helping educators develop strategies for improving
student well-being and academic success.

PAYMENT TO PARTICIPANTS
THE RESEARCH PARTICIPANTS WILL NOT RECEIVE ANY PAYMENT IN PARTICIPATING THIS
STUDY.

PARTICIPANT CONFIDENTIALITY
Your name will not be associated in any publication or presentation with the
information collected about you or with the research findings from this study. Instead, the
researcher(s) will use a study number or a pseudonym rather than your name. Your identifiable
information will not be shared unless (a) it is required by law or university policy, or (b) you give
written permission.

Permission granted on this date to use and disclose your information remains in effect
indefinitely. By signing this form you give permission for the use and disclosure of your
information for purposes of this study at any time in the future.

REFUSAL TO SIGN CONSENT AND AUTHORIZATION


You are not required to sign this Consent and you may refuse to do so without affecting
your right to any services you are receiving or may receive from the functional program that
can be developed from this study. However, if you refuse to sign, you cannot participate in this
study.
CANCELLING THIS CONSENT AND AUTHORIZATION
You may withdraw your consent to participate in this study at any time. You also have
the right to cancel your permission to use and disclose further information collected about you,
in writing, at any time, by sending your written request to: Craig N. Refugio, Research
Coordinator, College of Teacher Education, Negros Oriental State University.

If you cancel permission to use your information, the researchers will stop collecting
additional information about you. However, the research team may use and disclose
information that was gathered before they received your cancellation, as described above.

QUESTIONS ABOUT PARTICIPATION should be directed to:

Craig N. Refugio, PhD


Research Coordinator, College of Teacher Education
Negros Oriental State University-Main Campus 1
Dumaguete City

PARTICIPANT CERTIFICATION
If you agree to participate in this study please sign where indicated, then tear off this
section and return it to the data collector(s). Keep the consent information for your records.

I have read this Consent and Authorization form. I have had the opportunity to ask, and I
have received answers to, any questions I had regarding the study and the use and disclosure of
information about me for the study.

I agree to take part in this study as a research participant. By my signature I affirm that I
have received a copy of this Consent.

_______________________________ _____________________
Print Participant's Name Date

______________________________
Participant's Signature

This Informed Consent Form is designed for Negros Oriental High School, ensuring that the
school authorities are well-informed about the research, the rights of the students, and how
their data will be handled. It emphasizes the voluntary nature of participation and the
commitment to confidentiality and the welfare of the students involved.

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