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Institutional Review Board

Sample Form: Permission Letter to Parents

NOTE: NOT ON NDNU LETTERHEAD

Date

Dear Parent,

I am currently enrolled in the (please specify degree program) at Notre Dame de Namur University in Belmont, CA, and am in the process of conducting research for my (thesis).  The study is entitled (name of study).  This study has been approved by (head of organization).   Your son or daughter has expressed voluntary interest in participating in this study.

I am requesting your written consent to allow your son or daughter/guardian to participate.  Approximately (specify #) boys and girls from your child’s school will anonymously complete a 4-page questionnaire.  The questionnaire will be completed outside of class time and the survey process should take no longer than (#) minutes.

Due to the nature of the study, I am also requesting your voluntary participation.  The participation of (specify: e.g., either the adolescent’s mother, father, or guardian) would benefit this research.  Your participation would involve the anonymous completion of a 2-page questionnaire, to be completed (specify location, e.g., in your own home), and should take no longer than (specify time commitment, e.g., 20 minutes).

The individual results of this study will remain absolutely confidential and anonymous to all parties, including myself, and child’s academic institution.  The pooled data results will be utilized for this thesis project only.  The school/center administration has granted permission for this study.  Neither the school nor the individual participants will incur any costs.

Your approval to allow your son, daughter, or guardian to participate, along with your consent to participate in the study will be greatly appreciated.  There are two forms that require your signature, a minor consent form and a parent consent form.  I have provided two copies of each form.  Please sign one copy of each and return them in the enclosed self–addressed envelope.  The second copy is for your records.  Please feel free to contact me if you have any questions or require additional information at (researcher phone # or email address/contact info).

Sincerely,

Researcher name and affiliation

Attachment

cc:        Dr. Z, Research Advisor, NDNU

Contact Information