University of Antique
Main Campus
Sibalom, Antique
INFORMED CONSENT FORM FOR SURVEY
Title: Social Sensitivity: Reading the Mind in the Eyes and Emotional Intelligence
Purpose of this Research: This study aims to test the social sensitivity of students from BS Marine Transportation
and BS Criminology students.
Description of this Research: This study will be conducting an experiment, composed of a pre-test, the actual test,
and finally, a written survey.
Potential Benefits: Your participation in this study would help the researchers to obtain data for our study.
Additionally, we will provide you the results and the implications afterwards.
Confidentiality: Full confidentiality will be assured. No information that discloses your identity will be released and
none will be published. The materials that contained the raw information derived from you will be destroyed after data
processing.
Publication: The results of this study may be published in any form for public and scholarly consumption used in
classroom instruction to enrich learning and generate more data for future research.
Participation: Your participation in this study must be voluntary and you have the right to withdraw if you feel
uncomfortable while in the process of gathering information.
Informed Consent: Given the above information, I confirm that the potential harms, benefits, and alternatives have
been explained to me. I have read and understood this consent form and I understand that I am free to withdraw from
my involvement in the study anytime I deem to be necessary or to seek clarifications for any unclear steps in the
research process. My signature indicates my willingness to participate in the study.
__________________________________________
Signature over printed name of Participant, Date
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University of Antique
Main Campus
Sibalom, Antique
INFORMED CONSENT FORM FOR SURVEY
Title: Social Sensitivity: Reading the Mind in the Eyes and Emotional Intelligence
Purpose of this Research: This study aims to test the social sensitivity of students from BS Marine Transportation
and BS Criminology students.
Description of this Research: This study will be conducting an experiment, composed of a pre-test, the actual test,
and finally, a written survey.
Potential Benefits: Your participation in this study would help the researchers to obtain data for our study.
Additionally, we will provide you the results and the implications afterwards.
Confidentiality: Full confidentiality will be assured. No information that discloses your identity will be released and
none will be published. The materials that contained the raw information derived from you will be destroyed after data
processing.
Publication: The results of this study may be published in any form for public and scholarly consumption used in
classroom instruction to enrich learning and generate more data for future research.
Participation: Your participation in this study must be voluntary and you have the right to withdraw if you feel
uncomfortable while in the process of gathering information.
Informed Consent: Given the above information, I confirm that the potential harms, benefits, and alternatives have
been explained to me. I have read and understood this consent form and I understand that I am free to withdraw from
my involvement in the study anytime I deem to be necessary or to seek clarifications for any unclear steps in the
research process. My signature indicates my willingness to participate in the study.
__________________________________________
Signature over printed name of Participant, Date
