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Introduction:
You are being asked to participate in a research study conducted by Stephanie Samar under the supervision of Dr. Mark Terjesen from St. John’s University. The decision to participate in this study is entirely up to you. You can decide to stop participating in this study at any time. If you have any questions, you may contact Stephanie Samar, the principal investigator.

Procedures:
The purpose of this research study is to explore how non-cognitive factors are associated with academic and life-long success. We would like you to provide your SJU student X-number in order to link your semester grades and SAT scores to your survey data. Once we obtain this data, your X-number will be deleted from our database and your answers will then be completely confidential and will not be traced back to you. The estimated participation time is 60 – 90 minutes. You will be asked basic questions about you as a person and your thoughts and beliefs about the world.

Benefits:
There are no direct benefits to you for your participation in this study. The information obtained from this study will further advancement in the knowledge and understanding of non-cognitive, non-IQ, related factors and how they impact academic success. At the conclusion of your participation, you will be provided with an opportunity to have your name entered into a raffle to receive one of three Amazon gift-cards.

Risks, Inconvenience, Discomfort:
There are no physical risks involved with participation in this study. Since we will be collecting your SJU student X-number, there is risk that a breach in confidentiality may occur. However, the study investigator is taking steps to minimize the chances of this occuring. Specifically, your SJU X-number will be stored in a password secured database separate from all other study data and only accessible by the study investigator. University X-numbers will be used to locate your university records to collect accurate SAT scores and semester GPA to be included in the analysis. Once these data are collected and entered into the main study database with survey results, your X-number will be destroyed and no identifying information will remain. No other identifying information will be collected. As a result, there is minimal risk involved with participation in this study.

Alternatives:
The alternative to this study is not participating. Your decision to not participate in this study will not have any negative implications for you; you may decide to withdraw from the study at any time or choose not to answer specific questions.

Confidentiality:
All information from this study will be kept strictly confidential. Your identifying university C-number will be stored separately from your study responses in a password protected file and destroyed at first chance. If any publications result from this study, you will not be identified. Any data from this study will be reported in aggregate form only; individual data responses will not be reported. Data from this study will be kept in a password-protected file.

Questions:
If you have any questions regarding this research study please contact either Ms. Samar at (347) 494-0140 or Dr. Terjesen at (718) 990-5860. For questions regarding your rights as a research participant, please contact Drs. Jay Zimmerman or Marie Nitopi from the Institutional Review Board at (718) 990-1440.

Thank you very much for your consideration. If you agree to participate, please consent by pressing the button below. Please print a copy of this form for your records.

 
 
Please indicate your choice below:
 
I voluntarily give my consent to participate in this research study. I understand that my pressing this button indicates that I have read and understood the information provided here. I understand that my participation is completely voluntary, and that my name will not be tied to the information I am providing. If at any time I do not wish to further participate, I have the right to withdraw my participation.
 
I do not wish to participate
 
 
 
Please provide your SJU X-number:
   
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
What is your current age in years?
   
 
 
 
What year in school are you currently in?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
Other
 
 
 
Please read the following statements and indicate how much each one represents you:
Very much like me Mostly like me Somewhat like me Not much like me Not like me at all
New ideas and projects sometimes distract me from previous ones.
Setbacks don’t discourage me.
I have been obsessed with a certain idea or project for a short time but later lost interest.
I am a hard worker.
I often set a goal but later choose to pursue a different one.
I have difficulty maintaining my focus on projects that take more than a few months to complete.
I finish whatever I begin.
I am diligent
 
 
Please indicate how accurately each statement represents you:
Very Inaccurate Moderately Inaccurate Neither Accurate or Inaccurate Moderately Accurate Very Accurate
I am the life of the party
I don’t like to draw attention to myself
I would describe my experiences as somewhat dull
I have little to say
I don’t talk a lot
I keep in the background
I feel comfortable around people
I make friends easily
I am skilled in handling social situations
I know how to captivate people
 
 
Please indicate how accurately each statement represents you:
Very Inaccurate Moderately Inaccurate Neither Accurate or Inaccurate Moderately Accurate Very Accurate
I am not easily bothered by things
I am very pleased with myself
I dislike myself
I often feel blue
I feel comfortable with myself
I seldom feel blue
I have frequent mood swings
I rarely get irritated
I am often down in the dumps
I panic easily
 
 
Please indicate how accurately each statement represents you:
Very Inaccurate Moderately Inaccurate Neither Accurate or Inaccurate Moderately Accurate Very Accurate
I have a vivid imagination
I believe in the importance of art
I tend to vote for liberal political candidates
I carry the conversation to a higher level
I enjoy hearing new ideas
I am not interested in abstract ideas
I do not like art
I avoid philosophical discussions
I do not enjoy going to art museums
I tend to vote for conservative political candidates