Order 1009471: Read Instructions
Today you will be a participant in an experimental paradigm, developed from already published psychological research. Your answers will be collected as data and analyzed in aggregate. There are no significant risks or benefits associated with your participation. Please sign below indicating your willingness to participate, for educational purposes only.
Name (Print): __________________________ Name (Signature): _________________________
[Short video will play. Please turn the page after video finishes.]
1. About how fast were the cars going when they hit into each other (mph)?
2. Did you see any broken glass? (Circle Answer)
Yes No
DEMOGRAPHICS
(Please circle the best answer when applicable)
1. What is your gender?
Female
Male
Other (specify)
2. Write your age (in years): ______________________
3. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?
White
Black or African-American
American Indian or Alaskan Native
Asian
Native Hawaiian or other Pacific Islander
From multiple races
Some other race (please specify)
4. Are you Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, Cuban-American, or some other Spanish, Hispanic, or Latino group?
I am not Spanish, Hispanic, or Latino
Mexican
Mexican-American
Chicano
Puerto Rican
Cuban
Cuban-American
Some other Spanish, Hispanic, or Latino group
From multiple Spanish, Hispanic, or Latino groups