PARENTAL CONSENT FORM

September 1, 2006

 

Dear Parents/Guardians:

This year your child's school will participate in a statewide social norms research survey being conducted with high school students in New Jersey.  The primary purpose of this survey, based on the social norms approach, is to learn about youth alcohol use, knowledge, attitudes, and behaviors.  The survey is being sponsored by the Rowan University Center for Addiction Studies in partnership with the New Jersey Department of Education,.  The information obtained from this survey will be used to develop and evaluate programs for decreasing alcohol, tobacco, and other drug use among New Jersey youth.

All students in the school will be asked to fill out an online questionnaire about their attitudes toward the use of alcohol, tobacco, and other drugs.  Students may skip any question that they do not wish to answer and may stop participating at any point.  Please note that your student's participation is voluntary.

The survey has been designed to protect your child's privacy.  Students will not put their names on the survey and no one will know how a particular student answers the questions.  No one form the school will be allowed to look at any student's completed survey.

You may choose to have a copy of the questionnaire ahead of time by calling Dr. Clauser, Principal.

If you have any questions, please contact Mr. Bailey, the project coordinator, at 732-905-3510.  If you have specific questions about the survey, you may contact Dawn McGinty at Rowan University (856) 863-2175, or the survey developer, Wesley Perkins, PhD at perkins@hws.edu or by calling (315) 781-3437.

_____Yes, my child may participate in this survey.

_____No, my child may not participate in this survey.

________________________________    _______________________________________

Parent's Signature                                              Student's Printed Name