Adverbial Morphemes in Tactile ASL - Gallaudet University
Adverbial Morphemes in Tactile ASL - Gallaudet University Adverbial Morphemes in Tactile ASL - Gallaudet University
PDE – Steven D. Collins Appendix E – Consent Form _________________________________________________________________________________________________________ Union Institute & University 440 E. McMillan Street Cincinnati, Ohio 45206-1925 513.861.6400 / 800.486.3116 TDD 800.486.9968 / Fax 513.861.0779 DOCTORAL PROGRAM INFORMED CONSENT FORM RESEARCH WITH HUMAN SUBJECTS Consent Form Steven D. Collins and Union Institute and University I hereby give permission for the videotapes or digital media and written information obtained during this interview to be used for research purposes. I understand that I can withdraw from participation at any time with no penalty. I understand that this information may be included in research publications and presentations and that the videotapes or digital media may be shown during presentations about the project. In addition, selected segments of the videotapes/digital media will be used in the preparation of comprehensive videotapes or digital media about the project, or training materials that will be based on research findings. I understand that neither I nor anyone I mention during this interview will be identified by name in any publication or presentation. (name print) (signature) (date) 121
PDE – Steven D. Collins Appendix F – Informant Background Information _________________________________________________________________________________________________________ F. Appendix F – Informant Background Information Informant Background Information Name: _________________________________________________ Address: ______________________________________________ City: _______________________ State: _______________Zip: _________________ Phone No. : _______________________________________________ (area code) Education information 1. When you were in elementary school, were you at: a. Deaf Institute b. Hearing school i. With interpreter ii. Without interpreter c. Mainstream program i. With interpreter ii. Without interpreter iii. Only with special group d. None e. Other: _____________________ 2. When you were in elementary school, which communication did you use: a. Oral b. Contact Sign (PSE) c. Sign English d. ASL e. Other: __________________ 122
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PDE – Steven D. Coll<strong>in</strong>s<br />
Appendix E – Consent Form<br />
_________________________________________________________________________________________________________<br />
Union Institute & <strong>University</strong><br />
440 E. McMillan Street<br />
C<strong>in</strong>c<strong>in</strong>nati, Ohio 45206-1925<br />
513.861.6400 / 800.486.3116<br />
TDD 800.486.9968 / Fax 513.861.0779<br />
DOCTORAL PROGRAM<br />
INFORMED CONSENT FORM<br />
RESEARCH WITH HUMAN SUBJECTS<br />
Consent Form<br />
Steven D. Coll<strong>in</strong>s and Union Institute and <strong>University</strong><br />
I hereby give permission for the videotapes or digital media and written <strong>in</strong>formation obta<strong>in</strong>ed<br />
dur<strong>in</strong>g this <strong>in</strong>terview to be used for research purposes. I understand that I can withdraw from<br />
participation at any time with no penalty. I understand that this <strong>in</strong>formation may be <strong>in</strong>cluded <strong>in</strong><br />
research publications and presentations and that the videotapes or digital media may be shown<br />
dur<strong>in</strong>g presentations about the project. In addition, selected segments of the videotapes/digital<br />
media will be used <strong>in</strong> the preparation of comprehensive videotapes or digital media about the<br />
project, or tra<strong>in</strong><strong>in</strong>g materials that will be based on research f<strong>in</strong>d<strong>in</strong>gs. I understand that neither I<br />
nor anyone I mention dur<strong>in</strong>g this <strong>in</strong>terview will be identified by name <strong>in</strong> any publication or<br />
presentation.<br />
(name pr<strong>in</strong>t)<br />
(signature)<br />
(date)<br />
121
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