Psychology Department Informed Consent Statement

Study Title: (use the same title given in your Ethics Proposal)

Experimenter(s): (provide the full name of at least one of the people responsible for running your study)

LOC Credit Value: (indicate closest value in 20 min. increments - 20 min., 40 min.,1 hour, 1 hour & 20 min, etc.)

Description of Experiment: (provide a sentence or two about the general activities participants will do)

In order to participate in this research study, it is necessary that you give your informed consent. By signing this informed consent statement you are indicating that you understand the nature of the research study and your role in that research and that you agree to participate in the research. Please consider the following points before signing:

• I understand that I am participating in psychological research;

• I understand that my identity will not be linked with my data, and that all information I provide will remain confidential;

• I understand that I will be provided with an explanation of the research in which I participated and be given the name and telephone number of an individual to contact if I have questions about the research. In addition, I understand that I may contact the Psychology Department Coordinator of Human Participants Research, Alan Tjeltveit, at 484-664-3420, if I have questions concerning my rights as a participant in psychological research or to report a research-related injury.

• I understand that certain facts about the study might be withheld from me, and the researchers might not, initially, tell me the true or full purpose of the study. However, the complete facts and true purpose of the study will be revealed to me at the completion of the study session; (If you are running a study involving deception, this clause is required.)

• I understand that participation in research is not required, is voluntary, and that, after