PLEASE REFER TO FOOTNOTES FOR GUIDANCE IN FILLING OUT THIS CONSENT
FORM
Postgraduate Dissertation/UG ISP
SOAS, University of London
Participant Consent Form for Postgraduate Dissertation/Undergraduate ISP1 Research
Study
Student Name2
Postgraduate Dissertation/Undergraduate Individual Study Project 1
SOAS, University of London
Title of Project:....2
Introduction
The purpose of this form is to provide you with information so you can decide whether to
participate in this study. Any questions you may have will be answered by the researcher or
by the other contact persons provided below. Once you are familiar with the information on
the form and have asked any questions you may have, you can decide whether or not to
participate. If you agree, please either sign this form or else provide verbal consent if you do
not wish your name to be registered on the form. Please also indicate whether or not you are
willing for your contribution to be audio recorded. Please note that this recording will not be
made available to anyone other than the student and if necessary the supervisor. It will only
be used for the purposes of transcribing the material.
Please note your participation is voluntary and you may decide to leave the study at any
time. You may also refuse to answer specific questions you are uncomfortable with. You
may withdraw permission for your data to be used, at any time up to DATE2 in which case
notes, transcriptions and recordings will be destroyed. Withdrawal or refusal to participate
will not affect your relationship with3…..
Purpose of the Study
You have been asked to participate in a research study about [insert brief statement about
the research in non-technical language simple enough to be understood by
uneducated persons]. The purpose of the research is [explain again in simplified
language].
Use of the data
The findings will be used to form part of my dissertation and will potentially be published
in.....4
1
Delete whichever does not apply
2
Please note that all text highlighted in red needs to be replaced with the appropriate information.
3
Include this statement only if you have been introduced to this potential research subject by an organisation
with which he/she has a relationship (church/mosque, school/university, NGO, etc. And insert the name of this
organisation at the end of the sentence. But make it clear to those in the organisation that they must not
discriminate against this person for not wishing to participate.
4
Delete or complete the sentence
1
PLEASE REFER TO FOOTNOTES FOR GUIDANCE IN FILLING OUT THIS CONSENT
FORM
Postgraduate Dissertation/UG ISP
SOAS, University of London
If you wish to receive a copy of the final dissertation once completed I will happy to provide
you with an electronic copy.5
Procedures to be followed
To assist my research I am asking you to agree to participating in a [personal
interview/focus- group discussion/survey/....]6. We can arrange a time and date which is
convenient to you once you have confirmed your consent. The [interview/FGD/survey/..] will
take no longer than xxx to complete. [Please make it clear if this person will be asked to
participate more than once how many times and in what procedures and how long
each is likely to take]
Risks7
There are no foreseeable risks from participating in this study.
Compensation
You will not receive any type of payment for participating in this study.
Possible benefits of the study8
Statement of Privacy and Confidentiality
In any publication based on the findings of this study, the data presented will contain no
identifying information that could associate it with you unless you specifically request to have
your real name associated with your responses.
Contact Information
My telephone number is:9
My email address is:
Alternatively, you may wish to contact my supervisor, Professor/Dr. at (email/office phone).10
5
6
If you have a substantive reason for not providing this then omit this sentence
Clarify exactly what kind of procedure/s you want people to participate in
7
UG and PGT students will not be allowed to carry out research that is considered to pose risks to the research
subjects.
8
If there are direct benefits that may reasonably be expected from this project then list them under the
statement: The possible benefits of participation are ...... If not then delete this heading.
9
This should be both your UK mobile number and a local number in the country concerned. If you don’t yet
have a SIM card from that country, state this here for now and explain for the ethics committee you will
include your number once you have one and before printing the consent forms. Then delete your explanation
when providing your in-country phone number.
10
If fieldwork is taking place outside the UK please add contact details for a local contact person supporting
your study who can be trusted by the research subject
2
PLEASE REFER TO FOOTNOTES FOR GUIDANCE IN FILLING OUT THIS CONSENT
FORM
Postgraduate Dissertation/UG ISP
SOAS, University of London
Confirmation and consent
I confirm that I have freely agreed to participate in the research project of STUDENT NAME2.
I have been briefed on what this involves and I agree to the use of the findings as described
above. I give/ do not give permission for the interview to be recorded. The recording will be
used only to ensure the correct transcription of the interview and will be heard by me alone.
Participant signature:__________________________________________________
Name:________________________________________________________________
Date:_________________________________________________________________
I confirm that I agree to keep the undertakings in this contract.
Researcher signature:___________________________________________________
Name:__________________________________________________________________
Date:___________________________________________________________________
Please keep this form for future reference.
f:\research\research integrity\final documents\6. sample participant consent form soas
final.docx
3