If approval is granted, student participants will complete the survey in the classroom or other

quiet setting on the school site. (during recess, during school time, lunch, after high school and
ask permission for use of this time as well). The survey processes should take no longer than one
(1) hour. Individual results of this study will remain absolutely confidential and anonymous.
Should this study be published, only pooled results will be documented. No costs will be
involved by either the school on the individual participants.

Your approval to conduct this Study will be greatly appreciated.

Approved by:

___________________ ________________ _______________

Name Signature Date