Date

Mr. X
Principal/Head of School or Center
Address

RE: Permission to Conduct Research Study

Dear Mr. X:

I am writing to request permission to conduct a research study at your institution or (e.g., after school
center). I am currently enrolled in the (specify program) at (specific institution), and am in the process of
writing my (i.e., Master’s Thesis). The study is entitled (specify) and has been approved by Hillsborough
County Public Schools (approval letter enclosed).

I hope that you, the school administration, will allow me to recruit (i.e., specify x number of individuals,
boys, girls; indicate age of children) from the school to anonymously complete a 3-page questionnaire
(copy enclosed). Interested students, who volunteer to participate, will be given a consent form to be
signed by their parent or guardian (copy enclosed) and returned to the primary researcher at the beginning
of the survey process.

If approval is granted, student participants will complete the survey in a classroom or other quiet setting
on the school site. (Indicate when and where i.e., recess, during school time, lunch, after school and ask
permission for use of this time as well). The survey process should take no longer than (specify time
commitment). Parent participants would complete the survey at home. The survey results will be pooled
for the thesis project and individual results of this study will remain absolutely confidential and
anonymous. Should this study be published, only pooled results will be documented. No costs will be
incurred by either your school/center or the individual participants.

Your approval to conduct this study will be greatly appreciated. I will follow up with a telephone call next
week and would be happy to answer any questions or concerns that you may have at that time. You may
contact me at my email address: _________________________________.

If you agree, kindly sign below and return the signed form in the enclosed self-addressed envelope.
Alternatively, kindly submit a signed letter of permission on your institution’s letterhead acknowledging
your consent and permission for me to conduct this survey/study at your institution as I will provide it for
participants.

Sincerely,

Researcher name and affiliation

Enclosures

cc: Dr. X, Research Advisor, University/Institution School

Approved by:

_____________________ ____________________ _________

Print your name and title here Signature Date