UMERC– 005

University of Mindanao
Rev. 01 /December 1, 2016
Form E. Informed Consent Form Approved by:

when Questionnaires are Used Control No.: _______________

University of Mindanao Ethics Review Committee

Matina, Davao City

IMPORTANT: All fields must be completed.

Research Title: Teacher Behavior and Student Attitude towards English

Language Learning
Researcher: Phee May P. Diel
Date Submitted: September 11, 2019

Date Received: _______________________

The information sheet and consent form C NC N/A

a Describe the nature and purpose of the questions to be asked /
b State that the participant/s is/are free to not answer any question /
c Clearly state, where applicable, that some of the questions may prove /
embarrassing for the participant
d Clearly state, where applicable, that the interviews (in-depth or focus group /
discussions) are likely to be audio or video taped.
e Clearly mention, where applicable, how and for how long the tapes/ files are /
going to be stored
Legend: C – Complied NC – Not Complied N/A – Not Applicable

Submitted by

Name Signature Name Signature

_Phee May P. Diel_ _____________ _______________________ ______________

______________________ _____________ _______________________ ______________
______________________ _____________ _______________________ ______________

Endorsed by/ Recommended by ________Ana Helena Lovitos, Ph.D._______

Research Adviser/ Mentor

Date Filed: ________________________________________________