Project Permission Form: Family Oral History Interview

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This is a permission form for family members interviewed by students in Dr. Wes Fryer's classes at Providence Day School. More information about this lesson / unit is available.

Email *

Record my email address with my response

First and last name of student conducting the interview: *

First and last name of family member being interviewed: *

(the "interviewee")

We understand...

This is an interview for a PDS middle school Computer Class assignment. This audio recording will be shared with others, depending on our selection below. We will discuss THE QUESTIONS to be asked in the interview BEFORE starting.

We both give our permission: *

To only share this interview audio with other students, teachers, and families at our school

To share this audio interview with the PDS community AND publicly on Dr. Fryer's student oral history projects Anchor / Spotify channel (anchor.fm/middlevoices)

Audio Interview Photo

It is OPTIONAL to take a "selfie photo" to accompany this audio interview. If one of you (the student or the family member being interviewed) prefer NOT to take and share a "selfie photo," the student will select a free photo from Unsplash.com related to a topic from the interview to turn in with this project.

Project Photo Preferred? *

We will take a "selfie photo" to share with our audio interview

We prefer to use a related Unsplash.com photo in this project

Student initials *

By initialing this form, I (the student) give my permission to share this interview and photo as specified in these form responses:

Interviewee initials *

By initialing this form, I (the interviewee / family member) give my permission to share this interview and photo as specified in these form responses:

Submit

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