STUDENT ASSENT FORM

Project Title:

Middle School Students’ Intuitive Techniques for Solving Algebraic Word Problems

I have been asked to be part of a research project that will study how middle school students solve word problems. The following are important parts of this project:

· With permission from my parent/guardian and my teacher, I will be working with Ms. Michelle Roehler in a problem-solving session. We will be working at my school in a quiet area free from distractions. I will have my teacher’s permission to be away from my class. Ms. Roehler will ask me some questions about math, watch how I solve word problems, and ask me to explain my work for her.

· I will be given three word problems to solve on my own. These problems will not be graded, and I do not have to finish them. If I am stuck, I can ask for help.

· During the entire problem-solving session, there will be a tape recorder recording everything we say. Ms. Roehler will also be taking notes.

· I am allowed to quit any time before or during my problem-solving session. I am not required to participate if I do not want to.

· My name, school, and school district will never be used in this study to protect my confidentiality.

· The results from these sessions will be used to write a report that may be published in the future.

I, ___________________, agree to be part of this research project. I understand what is required of me and that I am allowed to quit at any time.

Student’s Signature: _______________________________ Date: ___________

Investigator’s Signature: ____________________________ Date: ___________