Personal/Intrapersonal Experience Report - Consent Form
We want to compare how people who attend comic book conventions and people who don't attend them feel about life. The Personal/Intrapersonal Experience Report (PIER) will ask you to indicate the degree to which 30 statements fit you personally. You will respond to each statement by clicking a circle on an adapted visual analogue scale which ranges from strongly disagree to strongly agree. The statements concern self-esteem, optimism, assertiveness, life satisfaction, interactions, and emotions. This should take less than five minutes to complete.
By helping us, you can enter a drawing for a FREE PASS to the entire convention at either WonderCon in San Francisco, California or Comic-Con International convention in San Diego, California. You can earn up to TWO entries in our drawing:
1. Complete this consent form and the PIER survey yourself.
2. Get a friend to fill it out also. This should be someone who would not want to attend the convention. (Although, you're welcome to refer friends who would also like the chance to win a pass for themselves too.)
Even though you will enter your name on this consent form (which would be necessary to know if you won one of the convention passes), we will not store the consent form information and your survey information in the same file, so that your scores will be anonymous to us when we calculate them. You will need to enter the same e-mail address on both forms because if you complete the PIER survey randomly or fraudulently, we will have to discard that information and then discard your contest entry. Only ONE entry per person is allowed. Multiple entries will have to be discarded because we can only use each person's information once.
Your participation in the study should cause no risk or harm. If any questions cause you discomfort, please discontinue. Your participation is voluntary. Should you decide to stop at any time prior to completing the form, you may do so without any penalty, and you can request an opportunity to complete a non-psychological survey for the convention organizers as an alternative way to enter the drawing for the free convention pass.
When we complete the study, we will e-mail your scores to you if you indicate (on the bottom of the PIER form) that you want to know them. Likewise, our eventual findings can be made available to you as well. All responses will be kept confidential. If we publish our results, we will not include any identifying information about any participants.
We will be pleased to answer any questions you may have about our research.
Dr. Travis Langley Department of Psychology Henderson State University E-mail: drtravislangley at yahoo
1. To show that you have read the above information about the study and give your voluntary consent to participate, enter your full name as your electronic signature:
2. Enter your complete mailing address in case you win the convention pass:
3. Enter your e-mail address. You will enter the same e-mail address on the PIER form so that we can be certain everyone who completes the PIER has first completed a consent form.
4. Only individuals age 18 or above can enter the drawing. Only individuals 18 or above can legally or ethically consent to participate in our study. Therefore, we must confirm age. This also helps us provide additional confirmation of identity in case you win the drawing.
Age (two-digit number, 18 or above): Gender:
5. If someone else asked you to take this survey, please enter the full name and e-mail address of the person who referred you to this survey (and thank them for us).
If you are completing our survey in order to enter a drawing, which one of you is entering the drawing? you the person who referred you
If the person who referred you is entering the drawing instead of you, please indicate why you did not enter the drawing yourself:
Submission date (today):
FIRST COMPLETE THIS FORM AND CLICK THE SUBMIT CONSENT FORM BOX:
AFTER YOU HAVE SUBMITTED THIS CONSENT FORM, RETURN TO THIS PAGE AND CLICK THE BLUE SURVEY BUTTON BELOW TO PROCEED TO THE PIER QUESTIONNAIRE.
Thank you very much!
About the questions you will be answering on the PIER survey:
Questions #1 & #4 come from the Life Orientation Test-Revised by Scheier, Carver, & Bridges (1994).
Questions #2-3 & #5 come from Diener et al.'s (1985) Satisfaction with Life Scale.
Questions #6-10 come from Rathus's (1973) Assertiveness Schedule.
Questions #11-20 are Rosenberg's (1965) Self-Esteem Scale.
Questions #21-30 come from Goldberg's (1999) International Personality Item Pool.