1. Consent Form

The research project title is “An examination of hospice volunteers' motivation and political orientation” which is being conducted by a Kennesaw State University student, Kremena Kirilova (telephone 678-468-4438 and Kremena_Kirilova@yahoo.com), under the supervision of Professor Ginny Zhan, who can be reached at: gzhan@kennesaw.edu
The reason for the research is to examine relationship between hospice volunteers’ motivation and political orientation. The participants will have an opportunity to express their understanding and idea of volunteering, and engage in reflection of their volunteer efforts. The results may benefit volunteer organizations in recruting, training and motivating volunteers.
The procedures are as follows: The participants will receive an e-mail from a volunteer coordinator with a link to a survey questionnaire on Survey Monkey. It’s completely voluntary, but if a volunteer would like to participate, then he/she will proceed to fill out the questionnaire. There are 9 demographic questions, 10 items on motivation and 9 items on political preferences. The entire survey will take no more than 15 minutes.
There are no anticipated risks or discomfort for the participants.
The responses are anonymous. The IP addressed will not be collected by Survey Monkey. It means that the researcher will not know who the respondents are. The researcher does not have access to the participants’ e-mail addresses since the link is sent by the volunteer coordinators.
Participation is entirely voluntary. The participants may choose stop anytime they wish.
The results of this participation are anonymous, and the study is confidential and will not be released in any individually identifiable form without the prior consent of the participant unless required by law. The researcher will not have access to the participants’ personal information.
The criterion for participation is that the participants are 18 and older, and they were/are hospice volunteers.
The participants may contact Kremena Kirilova at 678-468-4438 (kremena_kirilova@yahoo.com) with questions.

The purpose of this research has been explained and my participation is voluntary. I have the right to stop participation at any time without penalty. I understand that the research has no known risks, and I will not be identified. By completing this survey, I am agreeing to participate in this research project.

THIS PAGE MAY BE REMOVED AND KEPT BY EACH PARTICIPANT
Research at Kennesaw State University that involves human participants is carried out under the oversight of an Institutional Review Board. Questions or problems regarding these activities should be addressed to the Institutional Review Board, Kennesaw State University, 1000 Chastain Road, #0112, Kennesaw, GA 30144-5591, (678) 797-2268.



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* 1. Do you give your consent to participate in the study?

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* 2. What is your age?

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* 3. What is you gender?

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* 4. What is your marital status?

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* 5. Highest level of education that you completed is:

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* 6. Family income:

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* 7. Would you describe yourself as:

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* 8. Would you say that you are ________ religious?

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* 9. Are you currently:

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* 10. Number of people in your household (including yourself):

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* 11. Please write the number that best expresses your opinion about the following questions:

  Strongly disagree Disagree Somewhat disagree Neither agree nor disagree Somewhat agree Agree Strongly agree
I feel compassionate toward the people in need
We need welfare to provide to the poor
I do not expect anything in return for my volunteering
I feel it is important to support the philosophy of the hospice
Society is more important than family
Services like health care, education and social security should be provided by the government, not by the private organizations
It's not worth raising interest rates to reduce inflation if this would result in the loss of large numbers of jobs
I am genuinely concerned about the particular group I am serving
Volunteer makes me feel important
By volunteering I feel less lonely
Shared religious belief isn't an important part of our society
By volunteering I can make new contacts that might help my business or career
If economic globalization is inevitable, it should primarily serve humanity rather than the interests of trans-national corporations
The wealthy shouldn't pay a larger proportion of their income in tax than the poor
Volunteering lets me learn things through direct, hands-on experience
Volunteering is an important activity to the people I know best
I feel it is important to help others
Social security system should be privatized

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* 12. Political orientation is usually described along a continuum from liberal to conservative. “Liberal” is usually taken to mean having a focus on equality, community, and the power of collective action. “Conservative” is usually taken to mean having a focus on individual responsibility and personal liberty.

  Liberal Moderate Conservative
Where do you see yourself along this continuum?

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