FM Community Assessment

You are invited to participate in a study entitled “A Fargo-Moorhead Community Assessment: Are the needs of the Lesbian, Gay, Bisexual, Transgender, Questioning, and Ally (LGBTQA) Communities in Cass (North Dakota) and Clay (Minnesota) Counties being met by the Pride Collective and Community Center (PCCC)?” We hope to learn what services or social, political, or psychological needs will benefit the LGBTQA Communities so that I may collaborate with the PCCC to offer the appropriate programs and services. You were selected as a possible participant in this study because you are at least 18 years old and because you are either:

On the PCCC Mailing Email list
On the email list of one of the ally organizations that collaborate with the PCCC
A patron/customer of local LGBTQA-owned or LGBTQA-friendly businesses in this area
An identified member of the Gay-Straight Alliance (GSA) or 10% Society Student
Clubs at North Dakota State University, Minnesota State University Moorhead,
Minnesota State Community and Technical College (M-State), or Concordia College
and we have permission to send the survey to you.

If you decide to participate, the survey may be found when you click this URL:

http://survey.mnstate.edu/limesurvey/index.php?sid=44338&lang=en

The survey should take no more than 30 minutes to complete. You will not be asked for information that would identify you therefore assuring confidentiality. There are no known emotional, physical, or social risks that will affect you. The only discomfort could come from the time it takes you to complete the survey. Once you begin the survey, you may stop at any time. Your answers will not be recorded until you click the “submit” button. The responses to the online survey will be recorded using a secure server at MSUM. Only the Principal Investigator will see the actual results.

If you prefer a paper copy instead of taking the survey on line, please write to, call, or email Dr. Richard K. Adler at Minnesota State University Moorhead at the post office address, phone number or email listed below. If you, a family member or friend wishes to take this survey, Dr. Adler will send him/her/them an email or they may also contact him for a paper copy. If someone needs the questions read to them and have someone write the answers that can be arranged as well.

Once you click submit, you are giving your implied consent. If you are completing the survey in another form other than the online version, your implied consent is automatic once you turn in the survey.

You may discontinue the survey at any time. If you log out of the survey, none of your responses will be recorded. If you choose to answer only some of the questions, that is totally acceptable. Again, once you click submit or turn in the paper survey, your answers will be recorded (but without identifying information).

No photographs, audio or video tapes will be used. The results will be tabulated and used to increase programming at the PCCC and collaborative programming with MSUM. If requested, the results will be shared with the Student Affairs Offices or GSA directors at each of the colleges. Data will be stored for three years in a locked cabinet in the Principal Investigator’s office at MSUM. After three years of storage, the data will be destroyed.

Your decision to participate or not will not prejudice your future relationships with your college, local businesses, the PCCC, Minnesota State University Moorhead, or other Greater Fargo-Moorhead entity. If you have questions about your rights as a participant in this survey, please contact the MSUM Institutional Review Board at wengerk@mnstate.edu or 218-477-2344. If you have questions about your personal rights, the survey or the results, please contact:

Dr. Richard K. Adler–Minnesota State University Moorhead
1104 7^th Ave. South–153 Frick Hall
Moorhead, MN 56563
218-477-2474—richard.adler@mnstate.edu

You will be offered a copy of this form to keep. You are making a decision whether or not to participate. When you click submit you are indicating that you have read the information provided above and have decided to participate. If you turn in a paper survey or have someone read the survey to you and write your answers for you, your signature on this page indicates your agreement to participate in this study. Remember, you may withdraw at any time without prejudice after signing this form if you choose to discontinue participation.