Hate Crime Survey Part 1

CONSENT FORM

1) Title of Research Study: The Examination of Sexual Orientation Hate Crime Victimization and Support Groups among College Students who identify as LGBT

2) Purpose: The purpose of this study is whether it is socially acceptable to be gay, lesbian, bi-sexual and/or transgender (LGBT) by examining hate crimes committed against LGBT. We want to further research the available resources and support groups for the victims of hate crimes, both off and on campus at California State University, Chico and Butte College.

3) Risks: Some of the questions may cause emotional upset. Your participation in this study is voluntary. You may chose to drop from the study at any point while taking this questionnaire with no penalties.

4) Data Collection , Privacy , Procedure and Storage:
The subjects that are being surveyed have the right to privacy and confidentiality. We will use a number of methods to ensure your rights are being honored. All surveys will be taken as anonymous. No participant is asked to specify his or her name or any information that could lead to identification. The questions are formed to ensure none of your provided information can be traced back to you. You are signing this ensuring that you are at least the legal age of 18. When the data and surveys are finished being collected, he data stored on a computer will be put into a specific folder that can only be accessed with a password. The completed paper questionnaires and consent forms will then be put in a locked desk draw. The researchers will be the only persons with the password and access to the questionnaires at all times. You will be provided with the survey in a space that is both comfortable and private. This is a precaution to ensure other subjects do not see anyone’s survey but his or her own.

6.) Duration of Participation: Ten to twenty minutes

7) Contact Information:
Title: Professor
Department: School of Social Work (SWRK)

Office BUTTE 531
Campus Zip: 0550
Phone 530-898-5445
E-mail [email protected]

8) Consent Statement: I have read or had read to me the preceding information describing this study. All my questions have been answered to my satisfaction. I am 18 years of age or older and freely consent to my participation. I understand that I am free to withdraw from the study at any time.

I Agree