Consent Form

What is the purpose of this study? To understand how energy costs affect current Keene residents. 

What will I be asked to do and how long will it take? To answer the questions in the following survey, it should take 5-10 minutes. 

What are the benefits of this study? By answering the questions in our survey you will be contributing to our current research which will help the City of Keene better understand residential energy costs.

What are the risks involved? There are no risks to you involved in participating in this research.

Is being in this study voluntary? You may withdraw from this study at anytime without penalty.

What about confidentiality? To protect your confidentiality, we will not collect your name or address. All data will be stored on secure servers.

What if I have questions? If you have questions about the research study, please contact Maia Roderick ( or Lauren Peyser ( For questions about your rights as a research participant, contact

This research has been reviewed and approved by the Institutional Review Board at Keene State College (IRB code #413)

You must be 18 years or older to participate in this study.

By clicking "next" you indicate that you have read and understand the information above, are 18 years or older, and that you volunteer to participate.