“Going Out”

For non-GVSU affiliated research personnel

Grand Valley State University

Applicable FWA #: 00002829 Expiration Date: November 8, 2013

Individual Investigator’s Name: John A. Gipson Jr.

All research protocols submitted to the HRRC for review and approval will be covered by this Agreement during Winter 2013 in which John A. Gipson Jr. is listed as the principal or participating study personnel.

1. The above-named Individual Investigator has reviewed:

1. The Belmont Report: Ethical Principles and Guidelines for the Protection

of Human Subjects of Research (or other internationally recognized equivalent; see section B.1. of the Terms of the Federal wide Assurance (FWA) for International (Non-U.S.) Institutions);

2. The U.S. Department of Health and Human Services regulations for the

protection of human subjects at 45 CFR part 46 (or other procedural standards; see section B.3. of the Terms of the FWA for International (Non-U.S.) Institutions);

3. The FWA and applicable Terms of the FWA for the institution referenced

above; and

4. The relevant institutional policies and procedures for the protection of

human subjects.

2. The Investigator understands and hereby accepts the responsibility to comply with

the standards and requirements stipulated in the above documents and to protect the rights and welfare of human subjects involved in research conducted under this Agreement.

3. The Investigator will comply with all other applicable federal, international, state,

and local laws, regulations, and policies that may provide additional protection for human subjects participating in research conducted under this agreement.

4. The Investigator will abide by all determinations of the GVSU Human Research

final authority and decisions of the HRRC, including but not limited to directives to suspend or terminate participation in designated research activities.

5. The Investigator will complete any educational training required by the Institution

and/or the HRRC prior to initiating research covered under this Agreement.

6. The Investigator will report promptly to the HRRC any proposed changes in the

research conducted under this Agreement. The investigator will not initiate changes in the research without prior HRRC review and approval, except where necessary to eliminate apparent immediate hazards to subjects.

7. The Investigator will report immediately to the HRRC any unanticipated

problems involving risks to subjects or others in research covered under this Agreement.

8. The Investigator, when responsible for enrolling subjects, will obtain, document,

and maintain records of informed consent for each such subject or each subject’s legally authorized representative as required under HHS regulations at 45 CFR part 46 (or any other international or national procedural standards selected on the FWA for the institution referenced above) and stipulated by the HRRC.

9. The Investigator acknowledges and agrees to cooperate in the HRRC's

responsibility for initial and continuing review, record keeping, reporting, and certification for the research referenced above. The Investigator will provide all information requested by the HRRC in a timely fashion.

10. The Investigator will not enroll subjects in research under this Agreement prior to

its review and approval by the HRRC.

11. Emergency medical care may be delivered to research subjects enrolled in a

HRRC approved research protocol without HRRC review and approval to the extent permitted under applicable federal regulations and state law.

12. This Agreement does not preclude the Investigator from taking part in research

not covered by this Agreement.

13. The Investigator acknowledges that he/she is primarily responsible for

safeguarding the rights and welfare of each research subject, and that the subject’s rights and welfare must take precedence over the goals and requirements of the research.

PI Name: John A. Gipson Jr.

Degree(s): B.S., M.Ed. candidate in Higher Education

Address (City, State/Province, Zip/Country): 304 Manzana Ct. Apt. 3D, Walker, MI 49534

Phone #: 269-362-4670 Date:11/19/12

FWA Institutional Official (or Designee):

Paul J. Reitemeier, Ph.D.

Institutional Title: Chair, Human Research Review Committee (HRRC)

Address: 301-C DeVos, GVSU 401 Fulton St phone #: (616) 331-3197 Grand Rapids, MI 49504-6431 fax #: (616) 331-6040

Appendix C

You are being invited to participate in a survey because you have self-identified as African American within the Banner system and possess a GPA of greater than or equal to 3.0; your identity and GPA have not been disclosed to the researcher. The survey investigates your perceptions in regards to various factors that relate to student achievement. Your participation in this research is entirely voluntary and you may choose to stop the survey at any time. The electronic survey consists of 20 questions that will take approximately 5-10 minutes to complete.

Any information that you share will remain anonymous. Your name will not appear on any of the material and there will be no way to identify your answers. Printed results will be kept in the researcher’s office for three years, after which time they will be destroyed.

Your participation in this research is important in that it will help further our

understanding of factors that influence academic success for students who identify as African American. If you should have any questions about this project, you may contact me at the address listed below, or you may call the chair of the Human Subjects Review Board at 616-331-3197 or [email protected]. If you would like to receive the results of this research, please email the researcher and he will provide a link to the completed thesis in April.

I appreciate your participation.

Sincerely,

John Gipson Graduate Assistant

Grand Valley State University [email protected]

Appendix D

November 16, 2012 John Gipson

College of Education

Grand Valley State University John,

I will provide means for email communication for the following research project: Understanding High-Achieving African American Students: A Quantitative Study

at Grand Valley State University Principal investigator(s) – John Gipson

Invitee population – Black or African American undergraduate students enrolled in Winter 2013 with cumulative GPA of 3.0 or higher

Nature and timing of contact – One invitation and one reminder message per invitee, both sent via email during the winter 2013 academic year. Content of messages must be exactly as approved by HRRC, and must clearly state that GVSU has not disclosed GPA information to you.

The e-mail addresses will not be released directly to you, but will be used to distribute your messages from a GVSU mail server.

This use of the data is in compliance with both FERPA and GVSU policies.

Philip Batty