* California State Polytechnic University, Pomona
Informed Consent Form for Research Involving Human Subjects

You are being invited to participate in a research study, which the Cal Poly Pomona Institutional Review Board (IRB) has reviewed and approved for conduct by the investigators named here. This form is designed to provide you - as a human subject - with information about this study. The Investigator or his/her representative will describe this study to you and answer any of your questions. You are entitled to an Experimental Research Subject’s Bill of Rights and a copy of this form. If you have any questions or complaints about the informed consent process of this research study or your rights as a subject, please contact the Compliance Office within Cal Poly Pomona’s Office of Research at (909) 869-4215.

IRB Protocol Number: 10-102

Title of the Study:
Computer Science Education for Youth Survey

Description of the Research:
This study is to research parents’ perception of the importance for their children to develop computer science skills early during their education. The research is to determine if parents believe computer technology is becoming a critical part of today’s society where subjects within computer science should be treated as important as math, English and life science skills as oppose to a job skill usually taught much later in the education system.

The survey is designed for those who are parents with at least one child between the age of six to sixteen. The survey will not require you to provide any personally identifiable information such as your name, address, social security number, or ID number. In addition, the survey will not require for you to provide demographical information such as race, gender, or specific age. All information collected from the survey will be anonymous to the researcher, and upon completion of data analysis through aggregation, the raw data collected from participants will be destroyed.

If you have at least one child between the ages of six through sixteen, and is willing to participate in this research survey, you will be asked a series of twenty questions which can take up between 5 to 10 minutes. The information you provide will allow the research to identify various research questions assisting the researcher to derive at a conclusion relating to parents’ believes of importance for youth to start computer science learning in their educations.

Your participation in this research is voluntary, which you may choose not to participate or terminate your survey at any time without any obligations.

If you agreed to participate in this survey and meet the criteria of being a parent with at least one child at the age between six through sixteen, and you are at least 18 years old, simply agreed to give consent below. You may also print this consent form using a printer for your record.

If you have any questions regarding this survey, please feel free to contact:

Kan Wang
MBA Student at California State Polytechnic University, Pomona
Email Kanwang@csupomona.edu
Phone (951) 643-7798

Research Committee Chair: Dr. Jae Min Jung
Professor at California State Polytechnic University, Pomona
Email Jmjung@csupomona.edu
Phone (909) 869-2449

I agree to give consent and I meet the criteria stated above. Yes/No