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UCLA AMMP Teacher Consent Form

Dear Teacher,

Your school is working with the American Institutes for Research (AIR) in partnership with the University of California, Los Angeles (UCLA) to study the Applied Mathematics Mentorship Program (AMMP). The study is collecting information from teachers to learn about the AMMP model and how it affects their beliefs about math learning and instruction.  

You may be asked to participate in one or more of the following activities over the course of the study:
  • Teacher Surveys – The LAUSD research office will administer online teacher surveys prior to AMMP summer training and at the end of fall 2022. These 20-minute surveys will collect information about your instruction and beliefs as well as your perspectives of the usefulness of the program. Survey responses will be used only for research purposes.
  • Teacher Focus Groups – We will conduct focus groups with small groups of teachers to get feedback on the program. Focus groups will take place in the middle and end of fall 2022 and will be approximately one hour in length. We will record these sessions for data analysis but will not share the recording outside of the study team.
You will receive $50 gift cards for survey completion and focus group participation.

Benefits. Your participation in the study will contribute to an understanding of practices that support positive student achievement and outcomes in math. 

Freedom to Withdraw. Your participation in this research study is completely voluntary. There is no penalty for passing on any question that is asked or withdrawing from the study at any time. The introductory language to the survey and focus group protocol states that you may pass on any question that is asked or withdraw from the study without penalty.

Risks and Discomfort. There are no risks to participating in the study beyond those encountered in everyday life. The LAUSD research office and study team will protect your information by storing it in a secure computer environment that is password-protected, encrypted, and only accessible by selected members of the LAUSD research office and study team.

Confidentiality. Your individual data will not be shared with anyone beyond the study team and selected staff at the LAUSD research office. Individual teachers and schools will not be identified in final research reports.

Future Use of Information. We will remove any information from the data that could be used to identify teachers for use in future research without additional informed consent.

Privacy. AIR follows the confidentiality and data protection requirements of the federal Family Educational Rights and Privacy Act (FERPA). Responses to this data collection will be used only for research purposes. The reports prepared for the study will summarize findings across the sample and will not associate responses with specific teachers. We will not provide information that identifies you to anyone outside the study team, except as required by law.

More Information. If you would like more information about this study, you may contact Dr. Toni Smith at AIR at, or 202-403-5926. If you have any concerns or questions about your rights as a research participant, contact AIR’s Institutional Review Board (IRB), which is responsible for the protection of project participants, at, or toll free at 1-800-634-0797.
If you have read the above information and received answers to any questions you may have, please indicate whether you would like to participate in all or some aspects of the study and sign below.
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