Research Agreement Form

Research Participant Agreement

This agreement relates to your participation in a Diversity Avatar Stickers™ research project. The project’s purpose is to better understand the pain-points of diversity, equity, and inclusion(DEI), managers, officers, and advocates. We ask that you read, sign, and return this agreement so you know your rights and what to expect from us.

Please email or call us if you have any questions, concerns, or technical issues with signing.
Contact info: Tarzine Jackson,, +1-470-923-5072.

You’re not required to take part in this research project. You can end your participation or skip a question at any time. While we’d love to hear your perspective, your participation is completely voluntary. If at any point you no longer wish to take part or want to skip a question, please let us know.

We appreciate your participation. Your participation will be unpaid. You won’t receive any form of compensation for joining us for this session. Your time and input make it possible for us to improve our services. Unfortunately we’re not able to provide compensation for this session. By participating in this study, you agree to waive any right or claim relating to compensation for your participation in this study.

We’ll be using information from the sessions to understand what people expect and want from our product Diversity Avatar Stickers™ and the services we provide. We use what we learn to help others understand what’s important to support. You give us unlimited rights to use materials associated with your participation, except for some limitations on recordings as explained below.

We’d like to record this session. We may record video, audio, or photo recordings from this session to help us review our time together and make sure we understood what you shared. We may also share recordings to help tell stories about what people want and need. In all cases we’ll take written notes. We might share quotes from people we interviewed. Nothing shared will include your face, name or specific identifying information. When the research project is completed, we’ll delete the full recordings.

Please check below if you approve recording this session. At any time during the session, you can ask us to stop recording, or you can end the discussion.

  • I approve recording this session.

We’ll work to protect your privacy. We’ll remove information that could be used to identify you, such as your face, name or specific identifying information. (Your voice won’t be removed if you approved recording above.)
There’s more information in this Privacy Act Statement for Research.

You can withdraw your consent or change your mind about what you have shared with us. You can do this during the session, at the end of the session, or up to after the session by contacting: Tarzine Jackson,, +1-470-923-5072.

We appreciate you taking part in this session. Your perspective will help shape products and services for the American public.

Thank you very much for your time and feedback!

Your signature below means that you understand your rights and agree to the above.

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