Republic of the Philippines

Department of Education
REGION III- CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF OLONGAPO CITY
REGIONAL SCIENCE HIGH SCHOOL
EAST KALAYAAN, SUBIC BAY FREEPORT ZONE, OLONGAPO CITY, ZAMBALES

PARTICIPANT’S CONSENT FORM

Good day! We are students from Regional Science High School III. In conformity with
our subject Practical Research II, we are currently conducting a quantitative study with the
title “An Assessment on First-Aid Awareness and Skills Among RSHS III Students,” and we
are asking for your permission to participate in our study. The purpose of this study is to
investigate and evaluate if students are competent and have adequate first-aid awareness
and abilities. It also wants to determine if learners have any past experience in performing
first-aid. All of the information acquired as a result of your involvement will be critical to the
study's success.
In line with the Data Privacy Act of 2012, all data provided will only be used for the
sole purpose of the research. Participation in this study is voluntary and you are free to
decide to answer or not answer any question or withdraw from participating at any time. All
gathered information will be properly acknowledged and cited.
With this, the student-researchers will strictly follow the guidelines for ethical
research. The data will be accessible only to the student-researchers and research advisers.
The report analysis will only include data that are considered essential and will be
discussed anonymously. Likewise, your profile and other unnecessary characteristics will
not be published.
If you have any questions or clarifications related to this study, feel free to contact
us with the information provided below.
Chelzy Krishna T. Esquillo
Email: chelskrishna@gmail.com
Facebook/Messenger: https://www.facebook.com/chelskrishna%20Chelzy%20Esquillo

I, _______________________________________, a student from Regional Science High School III,

understand my right as a research participant and am giving consent for the involved
students-researchers to collect and process my data in relation to the purpose of the
research study. I also understand the research objective process. In this regard, I am willing
to take part in answering the questionnaires that they will provide.

_____________________________ __________________
Signature over Printed Name Date Signed

Address: East Kalayaan, Subic Bay Freeport Zone, Olongapo City, Zambales
Contact No.: (047) 252-6046/ (047) 252-1117
Email Address: rshs@deped-olongapo.com
Official Website: https://www.facebook.com/DepEdOC.RSHS3/
“Scientia Vinces: Through Knowledge, We Win”