INFORMED CONSENT

Participant Letter

Dear Sir/ Madam ______________,

I AM _______________________, a trainee teacher of IP !amp"# T"an$" %ain"n& I ha'e to cond"ct an action re#earch to f"(fi(( the re)"irement OF pi#mp pro*ram *i'en +, IP & The foc"# of m, re#earch i# _____________________________& Therefore, I -o"(d (i$e to #ee$ ,o"r permi##ion to cond"ct the re#earch in ,o"r c(a## a# -e(( a# to in'ite ,o" to participate in m, #t"die#& To thi# end.&&d"rin* the practic"m.&&e/tra -or$ no.&& A(( the information -i(( +e confidentia( and -i(( +e on(, "#ed for the p"rpo#e of the re#earch& 0o" ma, -ithdra- from the #t"d, at an, time& 0o"r rea( name and ,o"r ## name -i(( not +e "#ed in thi# #t"d, Than$ ,o"&

0o"r# tr"(,, N"rhafi1ah 2"#in&

Consent I, __________________________ ha'e +een informed of the aim of thi# re#earch and I *i'e permi##ion to cond"ct the #t"d, in m, c(a##& I a(#o a*ree to +e one of the participant# in the re#earch& I "nder#tand that a(( the information -i(( +e confidentia(& I ma, -ithdra- from the #t"d, at an, time& M, rea( name -i(( not +e "#ed in thi# #t"d,&

__________________ Date3