ASSENT FORM OF RESPONDENT IN THE STUDY

ASSENT FORM
This form provides you important information about the research study you are
being asked to participate in. Please read it carefully! When you are finished you
should know what the research study is about and what you will be asked to do.
If you agree to participate, you will be asked to sign this form. A copy of the form
should be given to you.
PURPOSE OF STUDY: We are conducting a research study about the
experiences of students with single parents’ and the challenges they have
experienced. This research study aims to give essential knowledge and
information to the respondent that can be contribute to your learning. In order to
do this, we need volunteers to participate in our research.
PRIVACY AND CONFIDENTIALY: The information collected in this research
study will be kept private and confidential. This means that we will do our best to
not let anyone see or hear the information you give to us while you participate.
I, ____________________________________ (your name: optional), have been
asked to take part in a research study entitled “UNSPOKEN PLEAS:
UNRAVELING THE JOURNEY OF SENIOR HIGH SCHOOL STUDENTS WITH
SINGLE-PARENT HOUSEHOLDS”. The study was thoroughly explained to me
by the researchers. I understand that I will be asked to complete the given survey
questionnaires. My participation in voluntary, and I can change my mind at any
time without any penalty. The person conducting the study will not reveal my
name to anyone, and my name will not appear in any reports on the study. I was
informed that if I have questions, I can approach Mr. Jacinth T. Dellosa, Mr. Hans
Ezekiel R. Jancinal, Mr. Edwin L. Ortillano Jr., Ms. Charmell Nicole M. Amar, Ms.
Elexa O. Bacalto, Ms. Angeline C. Carumayan, Ms. Marjorie A. Francisco, Ms.
Ain M. Lucero, Ms. Cyra E. Pantaleon, Ms. Liana Esza R. Toribio, and Ms. Shaira
Lyn G. Undalayan who can be contacted through mobile number
+639097426159.

_________________________ __________
Signature of Respondent Date

_______________________
Signature of Parent/Guardian