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Consent Form - Students

This document is a participant consent form for a project aimed at developing a critical listening teaching model using self-mediated podcasts to enhance critical thinking. Participants are informed about their rights, including the voluntary nature of their participation, confidentiality of personal information, and the use of their data in research outputs. The form also includes contact details for the researcher for any further inquiries.

Uploaded by

Arif Suryo Priyatmojo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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290 views2 pages

Consent Form - Students

This document is a participant consent form for a project aimed at developing a critical listening teaching model using self-mediated podcasts to enhance critical thinking. Participants are informed about their rights, including the voluntary nature of their participation, confidentiality of personal information, and the use of their data in research outputs. The form also includes contact details for the researcher for any further inquiries.

Uploaded by

Arif Suryo Priyatmojo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Participant Consent Form

Developing A Critical Listening Teaching Model with Students’ Self-Mediated Podcast to Enhance Critical Thinking

Please tick the appropriate boxes Yes No


Taking Part in the Project
I have read and understood the project information sheet dated 10/10/2024 or the project has been fully
explained to me. (If you will answer No to this question please do not proceed with this consent form until
you are fully aware of what your participation in the project will mean.)

I have been given the opportunity to ask questions about the project.

I agree to take part in the project. I understand that taking part in the project will include completing a
questionnaire, being interviewed, being recorded (audio and / or video, participating in experiment).

I understand that my taking part is voluntary and that I can withdraw from the study; I do not have to give
any reasons for why I no longer want to take part and there will be no adverse consequences if I choose to
withdraw.

How my information will be used during and after the project


I understand my personal details such as name, phone number, address and email address etc. will not be
revealed to people outside the project.

I understand and agree that my words may be quoted in publications, reports, web pages, and other
research outputs. I understand that I will not be named in these outputs unless I specifically request this.

I understand and agree that other authorised researchers will have access to this data only if they agree to
preserve the confidentiality of the information as requested in this form.

I understand and agree that other authorised researchers may use my data in publications, reports, web
pages, and other research outputs, only if they agree to preserve the confidentiality of the information as
requested in this form.

I give permission for the data that I provide to be deposited in [university data] so it
can be used for future research and learning

So that the information you provide can be used legally by the researchers
I agree to assign the copyright I hold in any materials generated as part of this project to Universitas Negeri
Semarang

Name of participant ……………………………….. Signature Date

Name of Researcher Arif Suryo Priyatmojo Signature Date

Project contact details for further information:


Researcher:
Arif Suryo Priyatmojo
Email : [email protected]
Phone : +62 85640975213
Affiliation : English Department, Faculty of Languages and Arts
Participant Consent Form
Universitas Negeri Semarang

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