Question Title

* 1. Instructions

The format may be modified and/or expanded, but the consent form should contain the elements included below, including the following heading. Please use language which the average lay person is likely to understand or which is appropriate for the age of the subject.

University of North Carolina at Asheville
Informed Consent for Participation in [Updates from the Milledgeville Summit]
[Nancy Ruppert, PI]
FWA# 00013541
IRB# 00006169


Introduction

• You are being asked to be in a research study based on a follow-up to the 2010 Milledgeville Summit
• You were selected as a possible participant because you are a middle level education professor or an advocate for middle level education.
• We ask that you read this form and ask any questions that you may have before agreeing to be in the study.

Purpose of Study

• The purpose of this study is to gain feedback from the topics we identified a year ago in Milledgeville that relate to areas that will promote middle level education.
• Participants in this study are from across the United States.
• There is no financial interest in this study by the investigator.

Description of Study Procedures

• Last summer (2011), middle level professors from around the country met in Milledgeville to honor the “Legacy Leaders” of the middle school movement and to look forward seeking a common vision of how to promote the middle school “movement”. At the meeting five topics were brought to light: leadership, licensure, teacher education, democratic education, and outreach. NaPOMLE (National Professors of Middle Level Education) set goals associated with these topics. The Endeavor is the document that came out of the Milledgeville Summit) is published twice a year and serves as communication for middle level advocates. We are looking to share feedback from members of NaPOMLE (National Professors of Middle Level Education) and from other leaders in the field of middle level education on the above topics to report what professors and leaders across the US are doing to promote middle level education. If you agree to be in this study, we would ask you to do the following things: 1) Respond to each of the areas as to how you have addressed them in your teaching, in your research, in your organization, or in your efforts to advocate for middle level education ; 2) Provide feedback as to ways professors and leaders could address the issue; and 3) Share issues of concerns in your efforts to address the issues.

Risks to Being in Study

• There are no forseeable risks to this study.

Benefits of Being in Study

• The benefits of participation are that we will be able to share what we are doing collectively with others. The summary of these activities could also be used to inspire collaboration and future research and activities.
• In that this was the first “working summit”, this study could also be part of a model for re-invisioning summits.

Payments

• There is no payment for participating in this research.

Costs

• There is no cost to you to participate in this research study.

Confidentiality

• The records of this study will be kept private. In any sort of report we may publish, you have the option of being identified as a participant. We will not include any information that will make it possible to identify a participant who does not wish to be identified. Research records will be kept in a locked file. Access to the records will be limited to the researcher; however, please note that sponsors and the Institutional Review Board may review the research records.

Voluntary Participation/Withdrawal

• Your participation is voluntary. If you choose not to participate, it will not affect your current or future relations with the NaPOMLE organization.
• You are free to withdraw at any time, for whatever reason.
• There is no penalty or loss of benefits for not taking part or for stopping your participation.

Contacts and Q

Question Title

* 2. There are five topics you will be asked to address. The first one has to do with leadership. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Question 2. Leadership was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to leadership? The first part of this question is a checklist. The second provides you an opportunity to share in narrative form what you have done.

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* 3. There are five topics you will be asked to address. The first one has to do with leadership.
For leadership, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Question 2. Leadership was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to leadership? This section provides you an opportunity to share in narrative form what you have done regarding leadership.

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* 4. There are five topics you will be asked to address. The second one has to do with licensure/certification at the state and national level. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Licensure/certification was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to licensure/certification? The first part of this question is a checklist. The second provides you an opportunity to share in narrative form what you have done.

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* 5. There are five topics you will be asked to address. The first one has to do with leadership. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Licensure/certification was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to teacher education? This section provides you an opportunity to share in narrative form what you have done.

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* 6. There are five topics you will be asked to address. The third one has to do with teacher education. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Teacher education was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to teacher education? The first part of this question is a checklist. The second provides you an opportunity to share in narrative form what you have done.

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* 7. There are five topics you will be asked to address. The third one has to do with teacher education. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Teacher education was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to teacher education? This section provides you an opportunity to share in narrative form what you have done.

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* 8. There are five topics you will be asked to address. The fourth one has to do with outreach. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Outreach was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to outreach? The first part of this question is a checklist. The second provides you an opportunity to share in narrative form what you have done.

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* 9. There are five topics you will be asked to address. The fourth one has to do with outreach. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Outreach was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to outreach? This section provides you an opportunity to share in narrative form what you have done.

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* 10. There are five topics you will be asked to address. The fifth one has to do with democratic education. For each of the following categories, identify work you have done, activities you are currently working on, concerns you have encountered, ideas you have. You do not have to answer all of the questions or each part. Thank you for your participation in this survey. If at any time you do not wish to continue, you do not have to.

Outreach was one of the topics addressed at the Milledgeville Summit. What activities and/or research have you engaged in related to democratic education? The first part of this question is a checklist. The second provides you an opportunity to share in narrative form what you have done.

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