I agree to participate in this project as an interviewee. I am aware that my interview will be edited and transcribed and then kept on file for use by researchers at the University of Connecticut Center for Oral History, which will hold the legal title and all literary rights including copyright, and may be used in publication and programs, including the world wide web, based upon the project. I grant permission for my interview to be used contingent upon my final approval. The Center agrees not to preclude any use I may want to make of the information in the recordings and/or the transcripts.

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Name of Interviewer                                                       Name of Interviewee

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Signature of Interviewer                                                                         Signature of Interviewee
 
 

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                                                                                  Address

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                                                                                                            Phone

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Date of Consent

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Date of Interview