Consent Form

Consent Form: Philosophy of Living Project

I want to do research on experiential learning. I want to do this because I many students seem to be getting results worth sharing from experiential projects I assign in some of my classes. I ask students to experiment by applying--or modifying or living in dialogue with--concepts for living that we study in class. Papers reflecting on these experiences in the light of classroom study often express concepts beautifully and tell educational and uplifting stories. Selections from student papers could make add significantly to a course website. In addition, in my speaking and writing, it would sometimes be valuable to have permission to share quotations from student writing and to retell inspiring stories. I will respect scholarly standards regarding plagiarism in my use of student writing. I would normally not use names when telling one of these good stories. Think how a student might feel who wrote a paper disclosing sensitive personal information that was woven into an inspiring story--and then saw that story with his or name in print. Good sense and the golden rule indicate a need for great discretion.

I would like you to take part in this project. If you decide to do this, you will be asked to permit me to make further use of the following paper, either in print, in speeches, or in electronic media such as a website.

Title of paper:

Date of original submission:

You should realize that there is the possibility that if your name is connected with a story that I publish, publicity may accrue to you, with some possibly unwelcome consequences. No compensation for unwelcome consequences from participating in this experiment is available.

If you take part in this project your achievements may be shared with a wider audience. Taking part in this project is entirely up to you, and no one will hold it against you if you decide not to do it. In particular, there are no consequences for your grade whether you participate or not. If you do take part, you may stop at any time, by informing me that I am to make no further use of your writing.

If you want to know more about this research project, please call me at 330-672-2315. This project has been approved by Kent State University. If you have questions about Kent State University's rules for research, please call Dr. Walter C. Adams, Interim Vice Provost and Dean, Division of Research and Graduate Studies, at 330-672-3012.

You will get a copy of this consent form.

Sincerely,

Jeffrey Wattles

Associate Professor of Philosophy

I select the following option by initialing my choice. (You must be at least 18 years of age in order to participate in this phase of the project.)

Mr. Wattles

_____ does not have my permission to make use of my writing

_____ may use my writing but must preserve my privacy by not using my name in connection with any writing of mine that he uses or story of mine that he publishes.

_____ may use my writing but must give credit to me by using my name in connection with any writing of mine that he uses or story of mine that he publishes.

I agree to take part in this project. I know what I will have to do and that I can stop at any time by contacting Mr. Wattles (330-672-0276; jwattles@kent.edu; Department of Philosophy, Kent State University, P.O. Box 5190, Kent, Ohio 44242-0001).

Student's name (clearly printed or typed as you would want it to appear in print)

__________________________

Student's signature_____________________________________ Date ___________