Appendix D: Student Consent Form
Student Permission Form
Writing Across the Curriculum Assessment
Informed Consent Form, 2010-2011
Gustavus Adolphus College is in the process of assessing its Writing Across the Curriculum program and its impact on student writing. As part of this process, your professor has been asked to submit a first and final draft of a paper from three students who were randomly selected by the statistician working with the assessment process. Your papers will only be shared with the Director of Writing, Writing Program Advisory Committee, and the Director of Institutional Research at Gustavus.
For this assessment project, we ask your permission to allow your professor to submit a first and final draft of a paper you wrote within the course. These papers, and the results of the surveys to be completed by all students in the class, will be used in a strictly confidential and anonymous fashion. That is, any reporting of results will NOT refer directly to students by name or course.
If you have any questions feel free to contact the Director of Writing Across the Curriculum, Dr. Jeanne Herman at 7614. firstname.lastname@example.org
Consent to Participate: I have read this informed consent form and agree to participate in the assessment study.
Please Print Name: ___________________________________________________
Student I.D. Number:___________________________
Thank you very much!
Your professor will return the signed forms to the Director of Writing.