Greetings from the Broadening Participation Planning Committee! We are delighted that you have decided to participate in our workshop this year! It is important to us that we learn a little more about each of our participants so we invite you to complete the survey that follows.

Project Title: Evaluating the Effects of Professional Development Activities on Broadening Participation of Underrepresented Groups

Investigator: Katherine Fu, PhD., Georgia Institute of Technology

You are being asked to be in a research study.

Purpose:
The purpose of this is to learn how about the impact of professional development activities and community building on broadening participation of underrepresented groups. Enrollment of up to 100 participants in this study is planned.

Exclusion/Inclusion Criteria:
For this study, you should:
· Be attending, plan to attend, or have attended in the past, a workshop hosted by the committee for broadening participation of underrepresented groups at the ASME International Design Engineering Technical Conferences (IDETC)
· Be attending or plan to attend the ASME International Design Engineering Technical Conferences (IDETC 2018) in Quebec City, QC, Canada
· Be at least 18 years of age
· Be able to give written consent
For this study, you should not:
· Be unable to meet the inclusion criteria in the list above

Procedures:
If you decide to be in this study, your part will involve:
· Three separate surveys
o One survey prior to attendance of the workshop
o One survey at the end of the workshop, on site at the conference
o One survey 6 months after the workshop
Remember, you may stop if you want to quit, and you may withdraw at any time. The total amount of time expected for participation in all phases of data collection will not exceed 1 hour. Participants should expect to spend no more than 10 minutes on each survey, for a total of 30 minutes across all three surveys.

Risks or Discomforts:
The risks involved are no greater than those involved in answering questions about ones’ personal experiences or self-confidence.

Benefits:
You are not likely to benefit directly in any way from participating in this research.

Compensation to You:
You will not be compensated for your participation in this study.
Confidentiality:
The following procedures will be followed to keep your personal information confidential in this study: The data collected about him will be kept private to the extent required by law. To protect your privacy, your records will be kept under a code number rather than by name. Your records will be kept in locked files and only study staff will be allowed to look at them. Your name and any other fact that might point to it will not appear if results of this research are presented or published. Once the study is complete, all records identifying your identity will be disposed of and deleted from all digital files. Your privacy will be protected to the extent allowed by law. To make sure that this research is being carried out in the proper way, the Georgia Institute of Technology IRB may review study records. The Office of Human Research Protections may also look over study records during required reviews.
You should be aware that the experiment is not being run from a secure https server of the kind typically used to handle credit card transactions, so there is a small possibility that responses could be viewed by unauthorized third parties such as computer hackers. In general, the web page software will log as header lines the IP address of the machine you use to access this page, e.g.,102.403.506.807, but otherwise no other information will be stored unless you explicitly enter it.

Costs to You:
There are no costs to you, other than your time, for being in this study.

In Case of Injury/Harm:
If you are injured as a result of being in this study, please contact Katherine Fu, Ph.D., at telephone (404) 385-3810. Neither the Principal Investigator nor Georgia Institute of Technology has made provision for payment of costs associated with any injury resulting from participation in this study.

Participant Rights:
Your participation in this study is voluntary. You do not have to participate in this study if you don’t want to be. If you decide not to participate, you will not be enrolled. You have the right to change your mind and remove yourself from the study at any time without giving any reason and without penalty. Any new information that may make you change your mind about participation in this study will be given to you. You do not waive any of your legal rights by signing this consent form.

Questions about the Study:
If you have any questions about the study, you may contact Dr. Katherine Fu, Investigator at telephone (404) 385-3810 or kfu@me.gatech.edu.

Questions about Your Rights as a Research Participant:
If you have any questions about your rights as a research participant, you may contact Ms. Melanie Clark, Georgia Institute of Technology, Office of Research Integrity Assurance, at (404) 894-6942 [or] Ms. Kelly Winn, Georgia Institute of Technology, Office of Research Integrity Assurance, at (404) 385- 2175.

CONSENT FOR THE COLLECTION AND PROCESSING OF SENSITIVE PERSONAL DATA FROM THE EUROPEAN UNION
1) Pursuant to the European Union General Data Protection Regulation (EU GDPR), the Georgia Institute of Technology (“Georgia Tech”), in its capacity as a data controller under the EU GDPR, must obtain your explicit, affirmative consent before it can collect or process any sensitive personal data for a lawful basis, including, but not limited to, employment, admission and enrollment, study abroad, internship abroad, online education, etc. For information on how Georgia Tech uses data, please review Georgia Tech’s Privacy notice at: http://www.gatech.edu/privacy
2) Any sensitive personal data that is collected from you will be for the sole purpose of participation in a research study Protocol# H16261 “Evaluating the Effects of Professional Development Activities on Broadening Participation of Underrepresented Groups” and is necessary for that purpose. This may include processing the sensitive personal data as required to execute contractual obligations in connection with the previously described purpose and compliance with applicable laws, to execute the obligations to you concerning your participation in a research study Protocol# H16261 “Evaluating the Effects of Professional Development Activities on Broadening Participation of Underrepresented Groups”.
Sensitive personal data regarding judicial measures which may have been provided to Georgia Tech by public bodies will be processed only for the purposes relating to a health or safety emergency and complying with any applicable EU law.

3) Sensitive personal data will be handled and processed only by the persons who are responsible for the necessary activities for the purpose above, and will be transmitted from the EU to the Georgia Tech Atlanta campus.

4) Refusal of consent may make it impossible for Georgia Tech to carry out its necessary activities for the purpose above, and may preclude Georgia Tech’s ability to provide requested participation in a research study.

5) You have the right to withdraw your consent to the collection and processing of sensitive personal data. If you would like to withdraw consent, please contact irb@gatech.edu.

6) Georgia Tech is committed to ensuring the security of your information. We have put in place reasonable physical, technical, and administrative safeguards designed to prevent unauthorized access to your information.

7) Georgia Tech has an EU GDPR Compliance Policy which includes your individual rights concerning your data. Please see the EU GDPR Compliance Policy here on the Georgia Tech Policy Library: http://www.policylibrary.gatech.edu/legal/eu-general-data-protection- regulation-compliance-policy

Having read this notice, I hereby give consent through the action of clicking “next” on this webpage, for the use of his/her sensitive personal data, and the transfer of sensitive personal data overseas, for the purpose outlined in this notice.

I also hereby waive my right to privacy of confidentiality regarding my EU institution host/employer reporting to the appropriate authorities at Georgia Tech if I am seriously ill, suffer an injury, am the victim or perpetrator of harassment, whether on or off campus, am the victim of the perpetrator of sexual or gender-based misconduct and/or of criminal behavior, whether on or off campus, and I grant the authorities of my EU institution host/employer staff, faculty and administrators full authority to report to the appropriate Georgia Tech authorities any and all such incidents, under the applicable laws (including but not limited to Title IX and the Clery Act), whether or not it involves disciplinary action.

If you have questions about this Consent, please contact irb@gatech.edu.

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