University of Michigan Graduate Employees’ Organization Strike Survey: Informed Consent Form
My name is Dr. Jacob A. Bennett, and I invite you to participate in this brief survey, the purpose of which is to gather demographic data from University of Michigan Graduate Employees' Organization members recently engaged in a labor strike, and to help answer the following research question: WHO IS STRIKING? At the conclusion of the survey you can indicate interest in participating in optional follow-up interviews at a later date, which will help answer the related research question: HOW DO STRIKING GEO MEMBERS DESCRIBE THEIR EXPERIENCES OF DIGNITY IN THE ACTION OF STRIKING? While the survey responses will help to outline the contours of the population striking, the interviews give individuals a chance to voice their perspectives and provide valuable insights into the meanings and experiences of dignity during a work stoppage.

Before describing the benefits and risks of participation, as well as issues of identity protection, data management, and plans after data collection, allow me to share some background on myself and the project. First, I have no affiliation with the University of Michigan, and am not conducting this research on behalf of, or with any obligations to, UMich or any other organization. The independent nature of the project means there is no Institutional Review Board approval; however, I am conducting the Web-based survey in comportment with Department of Health & Human Services guidance on human subject research, with additional guidance drawn from the American Association of Public Opinion Research advice on survey research, and will follow the same interview protocol that I designed for my dissertation research into adjunct faculty experiences of dignity, which was reviewed and approved by the University of New Hampshire's IRB while I was a doctoral student there. Above all, this research has been designed and will be conducted in observance of 45 CFR §46 - Protection of Human Subjects.

If you wish, please take a few minutes to review some of my previous and ongoing research at my Research Gate profile:

You will receive no direct benefits from participating in the survey component of this study.

There are no risks associated with your participation in the survey component of this study.

Taking part in this study is completely voluntary. The survey will only take a couple minutes to complete; while all questions require answers, no entries will be stored until you submit the form at the end of the survey.

Your survey responses will be collected through this Google Form and stored in a Google Sheets spreadsheet in a password protected electronic format. The survey does not collect identifying information such as your name, email address, or IP address, so your responses will remain anonymous. No one will be able to identify you or your answers, or to discover if you participated at all. To ensure this, I will only report data in aggregate and will never report on individual responses. I do plan to publish findings upon completion of the data collection. I will maintain the data in that protected environment for 3 years after completion of this research.

At the end of the survey you will have the opportunity to indicate interest in follow-up interviews* that I will conduct via Zoom, to be scheduled after survey completion. Your participation in the interview will not be linked to your survey responses, and the form to indicate interview interest will store your email address in a totally separate Google Sheets spreadsheet.

*There is a separate informed consent form to complete for the interviews, as the levels of risk and confidentiality differ from the survey.

If you have questions at any time about any aspect of the study, please don't hesitate to contact me at

With that, I wish you good luck and I hope you'll complete the survey and participate in follow-up interviews. Please submit only one response, but please also share widely with other GEO members.

In health and safety,
Jacob A. Bennett, M.F.A., Ph.D.
Please check "Yes" if the following are true: "I agree to participate in this survey as described above. I understand the purpose and nature of the survey. I understand the benefits and risks of participation and am participating voluntarily." *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy