Study of the Turnaround Schoool Leaders Program

Contract Number: ED-PEP-11-O-0088/TO28

Task Order 28

Implementation Study of the
Turnaround School Leaders Program

OMB Package

Consent Forms

Appendix M. Focus Group Consent Form

August 23, 2016

Prepared for:

U.S. Department of Education

Office of Planning, Evaluation and Policy Development

Policy and Program Studies Service

Prepared by:

Westat

1600 Research Boulevard

Rockville, MD 20850-3129

(301) 251-1500

and

Policy Studies Associates

1718 Connecticut Avenue, NW, Suite 400

Washington, DC 20009

(202) 939-9780

Implementation Study of the Turnaround School Leaders Program

Focus Group Participant Consent Agreement

The U.S. Department of Education Policy and Program Studies Service has contracted with Westat, a research company in Rockville, MD, and its partner, Policy Studies Associates in Washington, DC, to conduct an implementation study of the Turnaround School Leaders Program. Your district has agreed to participate in this study. As part of this study, we would like you to participate in this focus group. Focus groups with turnaround leaders and aspiring turnaround leaders are an important component of this study. It should take no more than one hour.

Your participation in this study is voluntary; you may withdraw from the study at any time and you are under no obligation to answer any focus group question. Responses to this data collection will be used only for research purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific individual. We will not provide information that identifies you to anyone outside the study team, except as required by law.

If you have any questions or concerns about the project, please contact Dan Aladjem, Study Director, at
(202) 939-5331 weekdays between 8 AM and 5 PM, Eastern Time (ET). He can be reached by email at daladjem@policystudies.com. The project director, Allison Henderson, may also be contacted regarding the study at (301) 251-4291 or at allisonhenderson@westat.com.

To help focus group facilitators verify their notes, we would appreciate your permission to audio-record this focus group. To ensure confidentiality, we ask that focus group participants do not discuss the specific comments made by others outside of the focus group session.

• I agree to participate in this focus group Yes No

• I consent to an audio-recording of the session Yes No

Printed Name

Signature of Participant Date

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is: XXXX-XXXX. The time required to complete this information collection is estimated to average 60 minutes per response.