Consent Form
LITERACYWORKS
Strategies for Success
Research and Development Project
This consent form is to verify your voluntary participation in this research project. All information, which could identify either your program or persons involved with your program, will remain strictly confidential. The final report will consist of aggregate information associated with the identified needs of literacy programs and adults with learning disabilities in the province. As a participant in this research, you will also receive a copy of the final report. I agree to let my information conveyed in this research be used in the aggregate report of the study findings.
Program Name: ____________________________________________________
Your Name: _______________________________________________________
Signature: ________________________________________________________
Date: ____________________________________________________________