You are being asked to take part in a research study of how college students with jobs manage their

school, leisure and work time. We are asking you to take part because you signed up at the SUSAN
web site for this study. lease read this form carefully and ask any !uestions you may ha"e before
agreeing to take part in the study.
What the study is about: #he purpose of this study is to learn how students who ha"e paid jobs
manage their class work. You must be working at least $% hours a week for pay to take part in this
study.
What we will ask you to do: &f you agree to be in this study, we will conduct an inter"iew with you.
#he inter"iew will include !uestions about your job, the hours you work, how much you earn, the
number of classes you take at 'ornell, how much you study, social and leisure acti"ities, your health
and well(being, and how much you sleep. #he inter"iew will take about )% minutes to complete. With
your permission, we would also like to tape(record the inter"iew.
Risks and benefits:
#here is the risk that you may find some of the !uestions about your job conditions to be sensiti"e.
*Note+ ,or studies posing no specific risks, use the &-. standard minimal risk statement, /& do not
anticipate any risks to you participating in this study other than those encountered in day(to(day life./0
#here are no benefits to you. 'ornell is a "ery demanding place to be a student and we hope to learn
more about students who work while earning degrees.
Compensation: You may earn e1tra credit if you are taking a class that offers credit for research
studies. #he class instructor will assign credit according to class policy. &f you wish, you may earn 2)
instead of e1tra credit.
Your answers will be confidential. #he records of this study will be kept pri"ate. &n any sort of report
we make public we will not include any information that will make it possible to identify you. -esearch
records will be kept in a locked file3 only the researchers will ha"e access to the records. &f we tape(
record the inter"iew, we will destroy the tape after it has been transcribed, which we anticipate will be
within two months of its taping.
Taking part is voluntary: #aking part in this study is completely "oluntary. You may skip any
!uestionsthat you do not want to answer. &f you decide not to take part or to skip some of the !uestions,
it will not affect your current or future relationship with 'ornell Uni"ersity. &f you decide to take part,
you are free to withdraw at any time.
If you have uestions: #he researchers conducting this study are -andy 4ackson and rof. Simon
'owell. lease ask any !uestions you ha"e now. &f you ha"e !uestions later, you may contact -andy
4ackson at randy5blabmail.com or at $(6%%(777(8)97. You can reach rof. 'owell at
meanguy5abbey.uk or $(6%%(777(8)97, e1t. $%%%. &f you ha"e any !uestions or concerns regarding
your rights as a subject in this study, you may contact the &nstitutional -e"iew .oard :&-.; at 9%<(=77(
7$)6 or access their website at http+>>www.irb.cornell.edu. You may also report your concerns or
complaints anonymously through ?thicspoint :www.hotline.cornell.edu; or by calling toll free at $(699(
=@)()%<<. ?thicspoint is an independent organiAation that ser"es as a liaison between the Uni"ersity
and the person bringing the complaint so that anonymity can be ensured.
You will be gi"en a copy of this form to keep for your records.
!tatement of Consent: & ha"e read the abo"e information, and ha"e recei"ed answers to any !uestions
& asked. & consent to take part in the study.
Your Signature BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Cate BBBBBBBBBBBBBBBBBBBBBBBB
Your Name :printed; BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
&n addition to agreeing to participate, & also consent to ha"ing the inter"iew tape(recorded.
Your Signature BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Cate BBBBBBBBBBBBBBBBBBBBBBBBB
Signature of person obtaining consent BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Cate
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rinted name of person obtaining consent BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Cate
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