CE

Department of Education

Region NA CALABARZON)

Division of Cavite

Trece Martires City, Cavite

Certificate Number: ATA 1T-01

Informed Consent

Title of the Study

Researcher(s)

Organization:

Contact Number(s):

You are invited to participate in this research study. Before you decide. It is important that you know

what the research is all about and why it is being done. The main purpose of this study is

The study will require session(s) of

it will require hours/minutes for you to complele the

Session(s).

The benefit (s) involved in participating in this study is/are

The risks)

involved in participating in this study is/are

. You may decline to answer

any or all questions and you may terminate your involvement at any time if you choose.

Your responses to this study will be anonymous. Please do not write any identifying information in

your questionnaire. Your comments will also be anonymous. We will ensure the confidentiality of your

data through

Respondent data will be kept confidential, except

in cases where the researcher is legally obligated to report specific incidents.

If you have questions at any time about this study, you may contact the researcher(s), whose

contact Information, isare) provided above.

Your participation in this study is voluntary. It is up to you to decide whether or not to take part in

this study, if you decide to take part in this study, you will be asked to sign this consent form. After you

sign the consent form, you are still free to withdraw at any time, and without giving any reason. If you

withdraw from the study before data collection is completed, your data will be destroyed.

Republic Act 10173, also known as the Data Privacy Act of 2012. "does not apply to personal

information processed for... research purposes...provided, that the personal information shall be held

under strict confidentiality and shall be used only for the declared purpose.

CONSENT

I have read and understand the provided information and have had the opportunity to ask

questions. I understand that my participation is voluntary and I am free to withdraw at any time,

without giving a reason and without cost. I understand that I will be given a copy of this consent form.

voluntarily agree to take part in this study.

Respondent's Name, Signature and Date

Researcher's Name and Signature

Rederorcas

Data Privacy Act of 2012 Retroved from httpswww privacy.gov.phidata privacy and

Roane Stute, Ind.), informed consent. Retrieved from www.onestaedu/webfolders WALLACEDA

/RB/ Informed Consent. 20 urte

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