INFORMED CONSENT FOR RESEARCH INVOLVING

HUMAN SUBJECTS

Title of Project: Why People Live In St. Pete

Principal Investigator: Joel Browdy
Contact Information: jwbrowdy@eckerd.edu
Other Investigators: N/A

This is to certify that I, _________, have been given the

following information with respect to my participation as a volunteer in research being
conducted under the supervision of Professor Nick Dempsey (faculty members name)

Purpose of the study:

To discover the patterns of why people live where they live, specifically focused in the St.
Petersburg community

Procedures to be followed:
Answering a series of questions related to the topic

Discomforts and risks:

Information relayed into an academic paper, under aliases

Time duration of the procedures and study:

A short in-person interview conducted on the streets of St. Petersburg by intercept model.

Statement of confidentiality:
Your participation in this research is confidential. Only the student(s) and supervising faculty
will have access to your identity and to information that can be associated with your identity. In
the event of publication of this research, no personally identifying information will be
disclosed.

Right to ask questions:

Any questions about the project can be directed to myself, Joel Browdy, at
jwbrowdy@eckerd.edu

Compensation:
Compensation is not applicable

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Voluntary participation:
I understand that my participation in this study is voluntary, and that I may withdraw from this
study at any time.

I have been given an opportunity to ask any questions about the research and my participation in
it, and all such questions or inquiries have been answered to my satisfaction.

By my signature below, I certify that I consent to participating as a volunteer in this research. I

have read this form carefully and completely, and understand the content of this consent form
and the meaning of my signing it.

Name of Participant: ____________________________________________________________

Signature: ____ Date:

Researchers Signature:

Signature of Parent/Guardian for Participants under eighteen (18) years of age: I certify
that I, as a parent or guardian with legal responsibility for the above named participant, consent
to and ratify participants release of Eckerd College, its employees, and agents, volunteers and
any students from all liability. For myself, my heirs, assigns, personal representatives and next of
kin, I release and agree to indemnify the releases from any and all liabilities incident to my minor
childs participation in the experiment, even if arising from the negligence of Eckerd College, its
employees, promoters or property owners, both known or unknown, to the fullest extent
permitted by law. I have read this release of liability, understand it, and fully agree to its
provisions.

Signature of Parent or Guardian: _____ ____ Date:

Printed name of Parent or Guardian: _____ ____

Researchers Signature: