Appendix T

Consent Form

Teachers’ Views on the Value of Homework at the Middle School Level

Participant Consent Form

Dear Colleagues,

            I have been given permission to conduct a research study on the value of homework in our school, and need your assistance in completing it.  If you give homework, are willing to take a few minutes to fill out a questionnaire and possibly sit for a follow-up interview, place an “X” in the appropriate parenthesis.

Please check one of the statements below and return this form to my school e-mail address, or mailbox, along with the questionnaire.

I, _________________________________, have received a copy of George Adams’s e-mail asking me to participate in his research project: Teachers’ Views on the Value of Homework at the Middle School Level.  Please note that if you do not give homework assignments you are not eligible for the study.  Should you choose to participate your responses will be held in the strictest confidence.  While results will be shared with the administration, no participants will be identified, either by name, or by discipline.

(Please indicate your willingness or refusal to participate by placing an “X” in the parenthesis next to the appropriate corresponding sentence.)

( ) I AM WILLING to participate in this study by responding to the questionnaire and possibly answering some follow-up questions.

( ) I AM NOT WILLING to participate in this study.

Name (Please print if using paper version):_________________________________

E-mail address______________________________________

Date___________________

Thank you in advance for your time and consideration.