African Identity Survey
This survey is to gather basic information prior to your interview. Please read the Informed Consent Notice below, prior to completing this survey. Completion of the survey implies that you consent to participating in the research project. Thank you for your participation!

University of North Texas Institutional Review Board

Informed Consent Notice

Before agreeing to participate in this research study, it is important that you know and understand the following explanation of the purpose, benefits and risks of the study and how it will be conducted.

Title of Study: Identity Formation among African Immigrants to the United States

Supervising Investigator: Dr. Ami Moore, University of North Texas (UNT) Department of Sociology.

Investigator: Giovanni N. Dortch, University of North Texas (UNT) Department of Sociology.

You are being asked to participate in a research study which involves the experiences of African Immigrants in the United States.

You will be asked to answer basic questions about your experiences in the US, through a 30 minute survey form, and interview, which will take about 1- 1 1/2 hours of your time. The interview will be conducted via conference call over the telephone.
It will take you a total of two hours to complete the survey and interview for this study.

The potential risks involved in this study are possible discomfort discussing experiences from the past, confidentiality of discussing personal matters of identity- such as unpopular beliefs or opinions, and risk of exposing immigration status. In order to address these risks, you may refuse to answer any question that may be uncomfortable to you without penalty or ask to stop the interview altogether. Aliases will be utilized when writing about you to protect your identity and your information regarding immigration status will be protected through the use of aliases.

We expect the project to benefit you by allowing an opportunity to share with your community and scholars the experiences of African Immigrants that may later be used to create policies to create better experiences and greater understanding between American citizens and Immigrant communities.

There is no compensation for participating in this study.

Demographic data – age, gender, country of origin etc ̶ will be collected through an online form. Although every effort to maintain confidentiality will be taken by the researcher, and there is a reasonable expectation of privacy through email forms, absolute confidentiality can not be guaranteed as this data will be collected through an online form and transmitted over the internet.

All interview data will be kept confidential through secure storage and retrieval mechanisms, and a confidentiality agreement with transcriptionists. When writing about interview data, the researcher will incorporate the use of aliases and engage in nondisclosure of participants’ personal information. The confidentiality of your individual information will be maintained in any publications or presentations regarding this study.

If you have any questions about the study, you may contact Giovanni N. Dortch via email at AfricanIdentity2014@gmail.com or the Faculty adviser Dr. Ami Moore at Ami.Moore@unt.edu or Dr. Erma Lawson at Erma.Lawson@unt.edu.

This research study has been reviewed and approved by the UNT Institutional Review Board (IRB). The UNT IRB can be contacted at (940) 565-3940 with any questions regarding the rights of research subjects.


Your participation in the survey confirms that you have been explained all of the above and that you agree to all of the following:

• Giovanni Dortch has explained the study to you and you have had an opportunity to contact her with any questions about
the study. You have been informed of the possible benefits and the potential risks of the study.
• You understand that you do not have to take part in this study, and your refusal to participate or your decision to withdraw
will involve no penalty or loss of rights or benefits. The study personnel may choose to stop your participation at any time.
• You understand why the study is being conducted and how it will be performed.
• You understand your rights as a research participant and you voluntarily consent to participate in this study.
• You understand you may request a copy of this form for your records.

African Identity Survey Part 1 Informed Consent Agreement
Please confirm that you are agreeing to participate in the study by entering your name, date and contact information
I certify that I have read the informed consent form and agree to participate in this study *
Enter your first and last name
Your answer
Enter Today's Date *
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Enter your best email address so that we can schedule and confirm your interview *
Your answer
Enter your phone number below so that we can schedule and confirm your interview. *
enter phone number with area code that you can be reached at
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