A Traveler's Guide to Literacy Research in Practice

Agreement to participate in an interview about the
use of arts-based approaches in adult literacy work
[Participants were practitioners]

Please check each statement to indicate agreement/choices. Send the completed form to Mary Norton [address]

I have read the information about the research project provided by Mary Norton [provided in a cover letter]
I agree to participate in a telephone interview e-mail interview about the use of arts-based approaches in adult literacy work.
I understand that as a participant in this research I have the following rights:

My participation is entirely voluntary.
I may choose to pass on addressing any questions that are posed.
I am free to withdraw from the research at any time.
I understand that if I choose to withdraw, my responses will not be included in any reports on the research.

I give permission to Mary Norton to transcribe or print out and use my interview responses for her research purposes.
I give permission to Mary Norton to use and quote from my responses as follows:

to share what is learned from the research with other participants in this research and with support group members, in order to review and extend the learnings;
to share what is learned from the research with participants in a workshop with literacy educators, in order to review and extend the learnings;
to prepare a report about the research for publication and distribution.

I wish to review how my responses and quotes are used in the report before it is published.

I wish to have my participation and quotes acknowledged in the report as follows:

Signature:

Date: