CONSENT TO PARTICIPATE IN A RESEARCH STUDY

Below is a description of the research procedures and an

explanation of your rights as a research participant. You should
read this information carefully. If you agree to participate, you
will sign in the space provided to indicate that you have read and understand the
information on this consent form. You are entitled to and will receive a copy of this form.
You have been asked to participate in a research study conducted by Prudence Whalen, a
student in the Department of Sociology at Dickinson College in Carlisle, PA. This faculty
supervisor for this study is Michael Stambolis-Ruhstorfer, a professor in the Department
of Sociology at Dickinson College.
WHAT THE STUDY IS ABOUT:
The purpose of this research study is to find out if there is a correlation between
students upbringing and socioeconomic background and their involvement, or lack
thereof, in the Why We Wear Black movement on Dickinsons Campus.
WHAT WE WILL ASK YOU TO DO:
During this study, the following will happen, the interviewer (Prudence Whalen), will ask a
series of questions regarding your involvement, if any, with the Why We Wear Black
movement. I will attempt to get a clear sense of why you are involved in the movement,
but also try to get a sense of where you come from, and see if there is a correlation
between these things and your involvement on campus.
DURATION AND LOCATION OF THE STUDY:
Your participation in this study will involve one interview that could last from anywhere
from thirty minutes to an hour and a half. The location of the study is TBD, but could take
place in any of these places: your dorm room, your dorm's common room, the Quarry, or
the Biblio.
POTENTIAL RISKS AND DISCOMFORTS:
The research procedures described above may involve the following risks and/or
discomforts: economic information regarding your family background. These questions
are being asked purely to gain a general sense of where you place on the social and
economic scale and you are free to decline any questions that make you feel
uncomfortable. If you wish, you may choose to withdraw your consent and discontinue
your participation at any time during the study without penalty.
BENEFITS:
You will receive no direct benefit from your participation in this study; however, the
possible benefits to others include the gaining information about the Why We Wear Black
movement, what it means to students on Dickinsons campus, and why people feel the
need to get involved or keep their distance from the heart of the movement. We hope to
learn if there is a correlation between students background and their participation, or
lack thereof, in the movement.
PRIVACY/CONFIDENTIALITY:
Any data you provide in this study will be kept confidential unless disclosure is required
by law. In any report we publish, we will not include information that will make it possible
to identify you or any individual participant. Specifically, we will not use your legal name,
but rather use pseudonyms and omit any other person identifiers if given (name, home
address, social security, etc.) from recorded interviews to keep your identity secure. I will
be the only person viewing the signed consent from and these will be stored in a locked
filing cabinet away from the data collected in this study. In addition to this, an encrypted

or password protected folder will be made that will contain the contents and information
given from your interview. Any personal identifiers will be deleted from any audio
recordings made.
VIDEO AND AUDIORECORDINGSFor this study I will be audio recording the interviews. I
am recording these interviews as it is important that I can transcribe the exact
conversation that we have. I will not begin recording until after all personal information
has been said. I will delete these audio recordings after I have finished transcribing the
interviews. I will not include your legal name in the transcripts, but rather a pseudonym.
COMPENSATION/PAYMENT FOR PARTICIPATION:
There is no payment or other form of compensation for your participation in this study.
VOLUNTARY NATURE OF THE STUDY:
Your participation is voluntary and you may refuse to participate without penalty or loss
of benefits. Furthermore, you may skip any questions or tasks that make you
uncomfortable and may discontinue your participation at any time without penalty. In
addition, the researcher has the right to withdraw you from participation in the study at
any time.
OFFER TO ANSWER QUESTIONS:
Please ask any questions you have now. If you have questions later, you should contact
the principal investigator: Prudence Whalen at (413)717-7749 or whalenp@dickinson.edu
. If you have questions or concerns about your rights as a participant in this study, you
may contact the Dickinson College Institutional Review Board at (717) 245-1309.
Additional contact information is available at:
http://www.dickinson.edu/homepage/78/institutional_review_board
I HAVE READ THE ABOVE INFORMATION. ANY QUESTIONS I HAVE ASKED HAVE
BEEN ANSWERED. I AGREE TO PARTICIPATE IN THIS RESEARCH PROJECT AND I
WILL RECEIVE A COPY OF THIS CONSENT FORM.

PARTICIPANT'S SIGNATURE

DATE
[IRB Rev. 09/19/12; modified from forms provided by Fairfield University]