Student Release Form

Dear Parent/Guardian:

Your child’s class at ______School is participating in a project funded by the National Science Foundation. The project is called “Getting the Media Message: The Portrayal of Gender, Race, and Information Technology in the Media Environment of Middle School Students.” The purpose of this project is to encourage middle school students to examine the way information technology careers are presented in various forms of media, including books, movies, and TV programs. As part of their class activities, the students will survey each other about what books they read and what movies and TV programs they watch. They will also look at the career information material available in the school media center and/or the public library. The students will analyze the books, movies, and materials that they identify to see how people—men and women and members of various racial groups—are presented regarding their involvement in information technology careers and activities. All information specific to individual students will be kept confidential. Your child’s teacher, ______, is working on this project with three professors from Ohio University. These professors are Phyllis Bernt, Communication Systems Management; Sandra Turner, Educational Studies; and Joseph Bernt, Journalism. If you have any questions about this project, please contact Phyllis Bernt by phone at (740) 593-0020 or by email at [email protected]. If you have any questions about your child’s rights as a participant in this class activity, contact Jo Ellen Sherow, Director of Research Compliance, Ohio University, (740) 593-0664.

Permission Slip

Student Name: ______

Your address: ______

I am the parent or legal guardian of the child named above. I have read and understand the information about this project. By signing this consent form, I agree to allow my child to participate in this class activity. I understand that no compensation is available from Ohio University and its employees for my child’s participation in this research.

Signature of Parent or Guardian: ______Date:______

Some portion of this class activity may be photographed or videotaped for use in a curriculum package for other teachers and to disseminate information about the findings of this project. (Please check the appropriate box below.)

I DO give permission to include my child’s image on videotape if this curriculum project is videotaped. I also give my permission to reproduce materials that my child may produce as part of this classroom activity. No names will appear on any reproduced materials.

I DO NOT give permission to videotape my child or to reproduce materials that my child may produce as part of classroom activities.