School of Divinity
ETHICS IN RESEARCH
Consent Form for participation and personal data to be used for research

Thank you for agreeing to participate in the research project, the details of which are:

Research Project name:
		
Name of researcher:
		
Researcher’s Contact details:
		
Scope of the project:

		
Confidentiality and Anonymity
(The researcher will indicate how confidentiality and anonymity will be preserved)

Please complete the following:

I consent to participating in this research project and understand that I may withdraw at any time.  YES  	NO   

I consent to my personal data, as outlined below, being held for use in the research project detailed above YES  	NO   

Researcher to specify personal data to be used for research

Signature:		
Date: