USDA NIFA AWARD No.2011-38422-31204 Award Title: Watershed Management Experiential Learning for USDA Careers Lead Agency: Cal State San Bernardino University Enterprises Corporation (FF20717) Award Period: 09/01/11-08/31/15

CSUSB USDA Internship Project: Intern Informed Consent for Data Collection

California State University San Bernardino (CSUSB), in collaboration with the CSU Chancellor’s Office Water Resource and Policy Institute, and numerous other CSU campuses are conducting this US Department of Agriculture-funded project to provide undergraduate and graduate students in the CSU system with paid internships, improved access to USDA summer internships and employment, and increase their involvement in water- and natural resource- related research. To ensure that the project is effective, and that each participant is engaging in developmental activities throughout the project and after the project has ended, we will be collecting various types of information and conducting a formal evaluation of the project.

The primary goal of this project is to increase the number of highly qualified undergraduate and graduate level students who gain the skills necessary to become employees of the USDA or its affiliate agencies and organizations. The success of the project will be determined by several sources of information. We seek your consent for certain activities to help determine the success of this project.

As an internship recipient we ask that you consent to provide access to academic data to determine eligibility and to track your progress to graduation. We will also collect performance feedback from your internship supervisors, faculty mentors, and research directors. You will also be asked to provide accurate contact data and to update that as changes occur from the beginning of your participation in this project until one year following graduation. You may also be asked to complete questionnaires regarding perceptions of the project and to participate in periodic evaluation interviews. These data collection efforts will be carried out solely to determine the success of the project activities, and to provide formative feedback to improve project activities as necessary.

The project staff will preserve confidentiality of information gathered through these activities. Any information you provide through these methods will be kept in secure files and only reported in aggregate with no individually identifying information will be used in evaluation reports without prior consent.

Your participation in project assessment activities is voluntary and will not affect your internship or employment opportunities. You may choose not to answer all or part of the questions on any questionnaire or interview, even after you sign this consent form. We anticipate that the benefits of participation in the project include enhanced research skills, scientific knowledge, increased motivation for water- and natural resource-related work, increased motivation to pursue graduate education, and improved employment opportunities. The training and mentorship received through being an intern are specifically designed to improve your short- and long-term job opportunities with the US Department of Agriculture, and its affiliate agencies.

If you have any questions regarding this project, please contact Dr. Lisa McElvaney (909) 537- 3687, Dr. David Zoldoske (559) 278-5669, or Dr. Rachel Weiss (909) 537-3315. You may also contact Dr. Jeff Thompson, Office of Academic Research at CSUSB (909) 537-5315 if you are concerned about your treatment as a research participant or the conduct of the project evaluation research staff.

Please sign and return this form. You can either send a scanned PDF version to Dr. Lisa McElvaney, Project Director at [email protected], OR you can FAX this document to the Water Resources Institute at CSUSB, Attn: Dr. Lisa McElvaney at Fax number 909-537-7682.

Thank you for your support of this most important project.

I have read the “Informed Consent”, understand what is being asked of me, and consent to participation in the data collection and evaluation research activities described for the assessment of the project.

Your Name (please print clearly): ______

CSU Campus: ______

Student ID: ______

Your Signature: ______Date: ______