RELEASE and CONSENT –[Name of Your Project]

 

[Your Name] is actively involved in a research project [specify topic] and plans to write articles and a book and make conference presentations detailing insights from that research. As part of this effort he will need to quote people like you whom I have interviewed. By signing the following release form you will give [Your Name] permission to cite you in this interview.

 

 

AGREEMENT

 

I (the undersigned) do hereby consent to and grant to [Your Name] the right to cite my reflections in this taped interview.  I understand and agree to ALL of the following in conjunction therewith:

 

  • [Your Name] may cite my words and use them in writing and publications.
  • I will receive no monetary compensation for these citations.
  • I have no literary property rights, copyrights, or other interest in the resulting recordings, or publications.

 

I am over eighteen (18) years of age and have read this release and consent and intend it to be a binding instrument.

 

Name __________________________________________________________________                                                                      

 

Address ________________________________________________________________

 

City _____________________________ State _____________ Zip Code ___________

 

Signature _________________________________________ Date _________________

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