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* 1. Clarkson University
Documentation of Informed Consent to Participate in Research

Clarkson University’s Institutional Review Board for Human Subjects Research has reviewed initial plans for this research and exempted it from further oversight. If you have concerns about the safety or conduct of this research, please contact the IRB at 315 268-6475 or email irb@clarkson.edu. 

Project Title: Consent to Access Faculty Demographic Data
Researcher(s): Laura Ettinger, Jennifer Knack, Sarah Treptow
Institutional Review Board (IRB) approval number: 20-52 E 

You have been asked to be a part of the research described here. Participation is voluntary.

Summary of the study: The purpose of this study is to obtain data from Human Resources regarding female STEM faculty so that a pool of potential oral history interview participants may be created. The activity will consist of a SurveyMonkey survey where participants will provide four pieces of data (gender, race/ethnicity, number of years at Clarkson University, and discipline). The survey will be housed online at SurveyMonkey. The survey will be two (2) minutes in length. 

What to expect: Each participant should expect a brief survey in which they provide data including gender, race/ethnicity, number of years at Clarkson University, and discipline. This survey should take approximately two (2) minutes to complete..

If you have any questions about this research, you may contact Dr. Laura Ettinger by email at lettinge@clarkson.edu or by phone at 315-268-3991.

Risks and discomforts to you if you take part in this study: There are no risks or discomforts for taking part in the study.

The benefits to you if you take part in this study: There are no direct benefits for taking part in the study.

What will you receive for taking part in this study: Participants will not receive compensation for taking part in the study.

What will happen to the information collected in this study: The survey results will be kept on password protected computers. The information collected will be kept confidential as much as is permitted by law.

What rights you have when you take part in this study: Participation in this research is voluntary. Deciding not to take part, or to stop being a part of this research will result in no penalty, fine or loss of benefits that you otherwise have a right to. 

Conflict of Interest: The researchers have no financial interest in performing this study.

Informed Consent: By clicking “I agree” you are indicating that you have read and understand the above information and that you agree to participate in this survey. In addition, by clicking “I agree” you are indicating that you are 18 years of age or older. If you do not agree, please exit the survey now.

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* 2. What is your name?

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* 3. What is your gender? _________________

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* 4. Are you of Hispanic, Latino/a, or Spanish origin?

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* 5. What is your race? (One or more categories may be selected)

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* 6. What year did you start working at Clarkson University?

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* 7. What discipline are you in?

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* 8. Are you willing to consider being interviewed in a follow up study?

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