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PARTICIPANT CONSENT FORM

Study title: To What Extent Does Membership of a Youth Group Diminish


the Likelihood or Effects of Bullying
Researcher name:

Ms Wez Hollin

Study reference: UCBC1WH


Ethics Committee Approved (if applicable): Yes

Please initial the box(es) if you agree with the statement(s):

I have read and understood the Information Form


(insert date/version no.)
I have had the opportunity to ask questions about the study

I agree to take part in this research project and agree for my data to
be used for the purpose of this study
I understand my participation is voluntary and I may withdraw
at any time without consequence

Name of participant (print name)


Signature of participant
Name of Researcher (print name)
Signature of Researcher
Date

Ms Wez Hollin
Wez Hollin
9 November 20 14

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UCBC6: Participant Consent Form September 2014 version 1

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