Consent Form

The purpose of this survey and research relates to practices of small and medium businesses in NEPA. We
are interested in learning how you engage with the community, participate in philanthropy, and contribute
to corporate social responsibility and sustainability. Your input is extremely valuable to us, and will help us
to convey the ideas and opinions of the business community to decision makers and stakeholders. We
expect the survey to take about 30 minutes of your time. Thank you so much for lending your voice to this
important research.

Your participation in this survey is voluntary. You may decline to answer any questions you do not feel
comfortable answering, or request that your responses be destroyed. Your responses will be kept
confidential, and presented in aggregated results. However, it will be possible for the researchers to
potentially I.D. respondents from the source code below. Your identity will not be shared and will remain
confidential.

You must be 18 to participate.
The 5-digit Source Code is used in lieu of your business’s name for identity confidentiality.

This project follows ethical guidelines in the use of human subjects and adequately safeguards the subject's identity, welfare, civil liberties, and rights. These steps will ensure there are no foreseeable risks to your organization's participation in the study. The Wilkes University Institutional Review Board has approved the research. Should you have concerns, you may contact one of the co-chairs: Dr. Joy Mao or Dr. Chris Zarpentine, IRB Co-chairs, or by visiting irb@wilkes.edu.

By completing this survey, you hereby give your consent to release this information to the principal
investigator for research purposes.

Should you need to contact us, please email business.research@wilkes.edu or call 570.408.2783.

Dr. Bulent Erenay (Principal Investigator), Assistant Professor of Operations, Wilkes University
The Research Team (who will collect and analyze data) includes Dr. Erenay and:
Dr. Marleen Troy, Professor of Environmental Engineering, Wilkes University
Dr. Jennifer Edmonds, Associate Professor of Statistics & Operations Management, Wilkes University
Prof. Ruth Hughes, Assistant Professor of Business Law, Wilkes University
Mr. Corey Golden, Associate Vice President/Investments, Golden Wealth Management
Jakob Chiasson, Lead Intern, Wilkes University

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* Do you agree to participate in the survey?

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* To participate in the research, please enter your five-digit code in the field provided. If you did not receive a code, please enter your email address.

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