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Sample Administrative Consent Form

An Administrative Consent Form is used when the researcher needs to video/audio-tape the interview or other activities.

Below is a sample Administrative Consent Form
[You can also download a PDF version. Requires Adobe Acrobat Reader to access it]

 

Administrative Consent Form

Audio Tape Release Form

I voluntarily agree to be audio taped during the interview being conducted by the [Name and the Organization of the Principle Investigator]. I understand that the tapes will be used to gather information about faculty's academic life, and such information will be used to generate a [possible kinds of work produced out of this project]. The tape will be kept for approximately one year and will be securely stored at [Name of the Organization of the PI]. After the data is collected and transcriptions are made, the tapes will be destroyed.

 

_______________________
________________________
My Signature
Date
_______________________
_______________________
Signature of the Investigator
Date

 

Refusal to be Taped

I do not agree to be audio taped during the interview conducted by [Name of PI and his/her Organization]. I understand that I will not receive compensation. By refusing to be audio taped, I understand that I may not continue to participate in the study.

_______________________
________________________
My Signature
Date
_______________________
_______________________
Signature of the Investigator
Date

 

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Sample Consent Form

PDF Version of the Sample Administrative Consent Form

 

 

 
   
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