**ADULT ESL LITERACY IMPACT STUDY**

**STUDENT CONSENT FORM**

I agree to participate in the Adult ESL Literacy Impact Study.

I understand that:

-   Participation in the study is voluntary; I can decline to
    participate in the study and still be placed into an ESL class.

-   The purpose of the study is to find out if instruction based on a
    new book is better at helping literacy students learn to read and
    speak English than the instruction usually used in my program's
    literacy classes.

-   I will be placed in either a class that uses the new book or a class
    that does not use the new book, based on a random lottery process.

-   My participation in the study will last one term (either fall 2008
    or winter/spring 2009).

-   I will be asked to participate in the following data collections:

1)  A short (30 minutes, maximum) literacy test in my native language
    during program intake (fall 2008 or winter/spring 2009);

2)  A short (30 minutes each, maximum) English literacy pre-test within
    the first two weeks of class, which will be audio recorded for
    scoring purposes; and

3)  A longer English literacy test and an English speaking and listening
    test at the end of the term (60 minutes each, maximum), which will
    also be audio recorded.

-   I will be paid \$40 after completing the tests given at the end of
    the term.

-   Study staff will also collect data from the program on my enrollment
    dates and attendance.

-   If I am randomly selected to attend the study class which uses the
    new book being studied, I will receive a free copy of the book. I
    may still have to purchase the program's usual book for my class.

-   All information I give is confidential and will be used only for the
    study, except as compelled by law. My name will never be used in
    reporting the results of the study.

-   I will tell project staff if I move or change addresses.

-   If I have any questions about my participation, I may contact Larry
    Condelli, project director, at either <ESLliteracy@air.org> or
    1-866-519-1884.

I understand the above and I agree to participate.

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_

**ADULT ESL LITERACY IMPACT STUDY**

**TEACHER CONSENT FORM**

I agree to participate in the Adult ESL Literacy Impact Study. I
understand that:

-   The purpose of the study is to evaluate whether a systematic
    literacy book (*Sam and Pat*) is effective in improving
    literacy-level adult ESL learners' reading and speaking skills.

-   The study is commissioned by the U.S. Department of Education\'s
    Institute of Education Sciences.

-   The study will last from the summer of 2008 through the spring of
    2009.

-   I will be assigned to teach a class that uses the *Sam & Pat* book
    or a class that does not use the *Sam and Pat* book, based on a
    random lottery process.

-   If I am assigned to teach a class that uses Sam & Pat, I will attend
    a three day training during the summer of 2008 on the use of *Sam
    and Pat*. I also will participate in a short (less than one day)
    webinar refresher training in January of 2009. I will be compensated
    for my time and any travel expenses incurred.

-   If I am assigned to teach a class that uses *Sam & Pat,* I will
    receive a copy of *Sam and Pat* before the fall 2008 term begins. I
    will not share the Sam & Pat materials or instructional methods with
    other non-*Sam & Pat* teachers at my school during the study.

-   If I am assigned to teach a class that does not use *Sam & Pat*, I
    will receive \$20 in materials funds in the form of a gift card. I
    will not use *Sam & Pat* books, materials or methods in my class
    during the study.

-   I will fill out the following forms or provide the following
    information as a part of participation in the study:

1)  Teacher Data Form (two times, summer 2008 and spring 2009) for which
    I will receive a small (\$15) stipend

2)  Daily student attendance in the study class

-   As a part of the study, I will be observed in my classroom three to
    five times during the study.

-   All information I give is confidential and will be used only for the
    purpose of the study. The information that I provide will not be
    released in such a way that would enable someone to identify me,
    except as compelled by law.

-   Participation in the study is voluntary. If I have any questions
    about my participation, I may contact Larry Condelli, Project
    Director, at either <ESLliteracy@air.org> or 1-866-519-1884.

I understand the above and I agree to participate.

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_