Hi, my name is ___________________. I am in the __th grade at _____________
___________ school. As the interviewer, I will be following strict guidelines
of ethical practices and recording standards. Whatever I write or produce must
be approved by you before it is submitted. I realize that this interview and
the photographs or other property you share with me will become part of a permanent
record. I am striving to do the most professional job I can.
For the record,
I need you to agree to and sign the following release:
I HEREBY GIVE MY CONSENT
TO The Arizona Heritage Project – Sharlot Hall Museum, to interview
me and to use my name. I also give my consent to photograph
me or my property and use likenesses in photographs, videotapes, CDs or DVDs,
or any other type of reproduction for any archiving, display, or other use
promoting these projects for historical documentation.
I DO NOT AGREE TO the
use of my interview or image or the use of my property for profit or for commercial
product endorsement. I understand that I have final approval of anything written
or produced. I consent to the use of the above without charge or fee.
____________________________ _____ __________________________ _____
Interviewer date Person giving consent date
______________________________ ______________________________
Teacher or supervisor
______________________________
______________________________
Address, telephone and contact information