You have been asked to participate in a research study conducted by Professor Danielle Wood from the Media Lab at the Massachusetts Institute of Technology (M.I.T.). The purpose of the study is to evaluate the outcomes of the Zero Robotics educational outreach program. You were selected as a possible participant in this study because of your participation in Zero Robotics. You should read the information below, and ask questions about anything you do not understand, before deciding whether or not to participate. We ask that parents or guardians sign this form on behalf of minor children under the age of 18.

• This interview is voluntary. You have the right not to answer any question, and to stop the interview at any time or for any reason. We expect that the interview will take about 30 minutes.

• The risks of this activity are minimal and no more than is encountered in every day life.

• You will not be compensated for this interview.

• Unless you give us permission to use your name, title, and / or quote you in any publications that may result from this research, the information you tell us will be confidential.

• We would like to record this interview so that we can use it for reference while proceeding with this study. We will not record this interview without your permission. If you do grant permission for this conversation to be recorded, you have the right to revoke recording permission and/or end the interview at any time.


This project will be completed by December 2028. All interview recordings will be stored in a secure work space until 2 years after the project findings are published. The recordings will then be destroyed.

Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission or as required by law. In addition, your information may be reviewed by authorized MIT representatives to ensure compliance with MIT policies and procedures.

I understand the procedures described above. My questions have been answered to my satisfaction, and I agree to participate in this study. I have been given a copy of this form.

Please contact Professor Wood with any questions or concerns at drwood@media.mit.edu or 6172531631.

If you feel you have been treated unfairly, or you have questions regarding your rights as a research subject, you may contact the Chairman of the Committee on the Use of Humans as Experimental Subjects, M.I.T., Room E25-143b, 77 Massachusetts Ave, Cambridge, MA 02139, phone 1-617-253-6787.