Consent to Use Personal Information in a Research Study

1. WHO IS CONDUCTING THIS SURVEY?

Graduate Student Society - UBC Vancouver
Vice President, External Affairs
225 – 6371 Crescent Road
University of British Columbia
Vancouver, BC V6T 1Z2
gss.ubc.ca

2. WHY ARE WE CONDUCTING THIS PROJECT?

The struggle for housing in Vancouver is a challenge for every UBC student. Off and on-campus housing for UBC students has the lowest rental vacancy rate in Canada. We want to know about your struggle to find peace of mind in the Vancouver housing market.

Your story can make a difference. Your Story – the story of UBC graduate student – has the power to move hearts and minds. It can drive the construction of new student housing on and around campus. It can enable the construction of higher density housing and it can bring peace of mind to graduate students at UBC for years to come. The Graduate Student Society (GSS) of UBC Vancouver is run by and for students. We don’t want the challenges faced by fellow graduate students to be forgotten.

My Housing Story is an initiative run by the GSS at mygradstory.ca where your voice can be heard, where graduate students can tell their story about their experiences fighting for space at UBC and in the Vancouver community.

3. WHAT WILL YOU BE ASKED TO DO?

Tell Your Story!

UBC graduate students can share their stories about the struggle to find accommodation, dealing with landlords that ignore government legislation with respect to evictions, rent increases, safety and maintenance, city bylaws, and violations of rental agreements.

* Send an Email
* Book a one-on-one confidential meetings
* Post a “PostSecrets” postcard
* Create a Video

If you choose to participate, you will be asked to submit a story of your housing experience. You may elect to submit this story online through the mygradstory.ca website, an email to housing@mygradstory.ca or in person via a one-on-one interview in a semi-private location on UBC campus (ie. a GSS office or a location of your choosing). If you wish to submit your story via a one-on-one interview, the interview will be audio-recorded and transcribed. However, you may ask that the audio-recorder be turned off at any point.

Prior to submitting your story, you will be asked to provide your written consent that you willingly agree to participate in the project. Consent can be revoked until the final report is published (publication date is estimated to be summer of 2017).
After your interview, and before the data are included in the final report, you will be able to review the transcript of your interview, and to add, change or delete information from the transcripts as you see fit.

You can request a copy of the results of this project.

4. HOW WILL THE INFORMATION BE USED?

The information that is gathered will be used in the production of a report that will be presented to the GSS Council and to UBC. The report will contain policy and procedure recommendations as to how the university and the government can better address housing issues faced by students. If you give us permission (optional), redacted quotes containing no personal information from your story may be used for advocacy purposes.

The GSS Vice President, External Affairs will provide you with copies of the report that results from this study upon your request.

5. WHAT ARE THE BENEFITS OF PARTICIPATING?

Through these stories submitted by UBC Graduate Students, the GSS hope to be better armed in advocacy efforts to create awareness about the struggles students face in finding safe, affordable accommodations.

6. IS THERE ANY RISK TO YOU FROM PARTICIPATING?

It is possible that you may become emotionally or psychologically upset during the process of participating in this study. There is a list of support resources you can access at you.ubc.ca. If you choose to participate in a one-on-one interview, you reserve the right to end the interview at any point and exit the project.

Every effort will be made to maintain the level of confidentiality requested in this consent form; however, an absolute guarantee of confidentiality cannot be provided. The GSS would be obligated to share confidential information with authorities in the event there is evidence you may harm yourself or others. Also, while highly unlikely, the Committee can be required to surrender information, if ordered to do so by a court of law.

7. HOW WILL YOUR IDENTITY BE PROTECTED?

No information that discloses your identity or the identities of others will be published. If you consent to allow the GSS to quote your statements in publications, you can note if there are statements you would like to remain confidential.

If you wish statements to be kept confidential, the GSS will take the utmost care to protect the details of your responses and your participation in this project. The data you are submitting electronically is received in a password-protected account that can only be accessed by the GSS Vice President, External Relations.

Stories will be redacted to remove any personally identifying information before being shared by the VP External Affairs. Your personal story will not be discussed by the Vice President, External Affairs outside of the purposes of this project. All information will be stored in a locked secure location and on an encrypted disk. All data will be destroyed after the publication of the Final Report.

In the event that a consent form is not completed, information will only be reported as part of an aggregated data set about housing issues experienced by UBC Graduate Students. The GSS won’t report what is learned about any one person. The GSS will only write about the combined responses of groups of people. For example, the GSS might say that 20% of our participants answered XYZ.

8. WHOM CAN YOU CONTACT IF YOU HAVE QUESTIONS ABOUT THE STUDY?

If you have any questions or desire further information about this study, you may contact the Vice President, External Affairs at vpexternal@gss.ubc.ca.

9. PARTICIPANT CONSENT OPTIONS

Please carefully review the options provided below and indicate your consent about how the information you provide to the Harassment and Discrimination committee will be used.

Right to Refuse or Withdraw

Sharing your story is entirely up to you. You have the right to refuse to participate in this project.
You have the right to omit information, as well as to withdraw completely from study and withdraw the information you submitted at any point during the process.

To provide clear consent, you are required to agree to one of the options for each item below.

By checking the boxes below, you shall indicate how you wish the information you will provide/provided on mygradstory.ca or in an interview with the GSS VP External Affairs to be shared or used.

1. I agree to participate in this study.

 Yes No

2. I understand that the VP External Affairs report will be provided to the GSS Council, various UBC administrators and possibly made public.

 Yes No

3. I permit information from my submission to be directly quoted in the VP External Affairs Housing Report.

 Yes No

4. I permit information from my submission to be referred to in general summaries about student housing at UBC.

 Yes No

5. I permit information derived from my submission to be used only as a part of an aggregated data set about student housing on UBC’s campus and in Vancouver.

 Yes No

BY CHECKING THE BOX BELOW, YOU ARE SIGNING THE CONSENT FORM AND ACKNOWLEDGING THE FOLLOWING: I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS CONSENT FORM PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS FORM I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.
  Yes, I have read and understood all the terms and conditions of this consent form

Type first, middle initial, last name:*

Email address:*

Signed this on this date:*

Please use this date format: January 1, 2017