City of Warrensburg Diversity and Inclusion Task Force Survey CONSENT
Identification of Researchers: This survey is conducted on behalf of the City of Warrensburg by Amber R. Clifford-Napoleone, Ph.D., a member of the City of Warrensburg Diversity and Inclusion Task Force and Associate Professor at the University of Central Missouri.

Purpose of the Study: The purpose of this survey is to get community opinions about the diversity of the city of Warrensburg.

Request for Participation: You are invited to take a survey about the diversity of the city of Warrensburg. It is up to you whether you would like to participate. If you decide not to participate, you will not be penalized in any way. You can also decide to stop at any time without penalty. Your answers are anonymous, will never be published or presented in public, and will only be used by city officials to improve services.

Description of Research Method: This study involves completing a survey about diversity and inclusion in the city of Warrensburg. The survey will ask you six Yes/No or Likert-scale (number scale) questions, as well as one area for comments that is not required. The survey should take no more than five minutes.

Privacy: All of the information we collect will be confidential. We will not record your name, student number, or any information that could be used to identify you. Your confidentiality will be maintained to the degree permitted by the technology used. Specifically, no guarantees can be made regarding the interception of data sent via the Internet by any third parties.

Explanation of Risks: The risks associated with participating in this study are similar to the risks of everyday life.

Explanation of Benefits: You will benefit from participating in this study by assisting in the continued improvement of services in the city of Warrensburg.

Questions: If you have any questions about this study, please contact Amber R. Clifford-Napoleone at clifford@ucmo.edu If you have any questions about your rights as a research participant, please contact the UCM Research Compliance Officer (660) 543-8562.

I agree to participate in the survey. *
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