7/27/2019 Duckworth Research ParentConsent Sample 25sept2013 (2).docx

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SAMPLE LETTER AND PERMISSION FORM.

* * Upon selection, the letter and permission form are developed jointl y between

the Duckworth Lab and the participating schools * *

* * * Please do not distri bute prior to selection * * *

Dear Families,

In the coming weeks, our school will be having Dr. Angela L. Duckworth, a psychology professor at the

University of Pennsylvania, conduct research at our school. Dr. Duckworth will lead a research project to

study the characteristics that lead to success in school. The study is called The Penn Study of High

Success and also involves other U.S. schools.

Participation in this project is voluntary. Students who participate will complete self-report questionnaires

and learning tasks on computers in our lab. Separately, their teachers may fill out questionnaires. Data

that is regularly collected for school records (e.g., GPA, standardized test scores) will be shared with theUniversity of Pennsylvania research team. Students will also be emailed/texted at periodic follow-up

(e.g., two weeks after the participate), reminding them of the effective study habits they learned about as

part of the study. All data collected as part of this study will be kept confidential and used for research

purposes only.

If you consent to your childs participation in this research project, you can simply keep this letter for

your recordsthere is no need to return the attached form. However, if for any reason you would

prefer that your child not participate in these activities, simply indicate this desireby checking the I do

not consent box on the following page and returning it to me. Your child will have the opportunity to

decline participation in this study at any time. Please do not hesitate to contact school administrators or

our colleagues at the University of Pennsylvania directly if you have any questions.

This is an exciting journey for all of us, and we thank all of our families.

Many thanks,

7/27/2019 Duckworth Research ParentConsent Sample 25sept2013 (2).docx

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Dear Parent,

If you permit your child to participate in the research project described in the attachedletter, you do NOT need to return this form. We thank you for your participation and look

forward to sending you interim updates on the results of the study.

However, if you prefer that your child does notparticipate in this research project, please initial the box

below, sign, and return this form as indicated on the previous page.

If you would like to speak with our research partners at the University of Pennsylvania, feel free tocontact Dr. Angela Duckworths graduate student Lauren Eskreis-Winkler. The address is 3701 Market

Street Room 207 Philadelphia, PA 19104, or you may email (eskreisl@sas.upenn.edu). If you would like

to speak with someone other than those working on the study, you may contact the University ofPennsylvania Office of Regulatory Affairs with any question, concern or complaint by calling (215) 573-2540.

I do not consent for my child to participate in the Penn Study of High Success. Onlyreturn this if you do not agree to let your child participate.

__________________________________________________

Parent Name (Printed)

__________________________________________________

Parent Signature

__________________________________________________

Child Name (Printed)

mailto:eskreisl@sas.upenn.edumailto:eskreisl@sas.upenn.edumailto:eskreisl@sas.upenn.edumailto:eskreisl@sas.upenn.edu