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Stephen F. Austin State University

Interviewee Release Form

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Interviewee Release Form

File size: 30.00 KB

Updated: Wednesday, January 09, 2013

EXAMPLE - Interviewee Release Form

This is an example of an interviewee release form. This form was used by Dr. Paul Sandul for an oral history project concerning the local African American Heritage project. Important points to note: who holds copyright, where materials will be held, listing of potential uses, release of liability, and restrictions.


I, _____________________________________, consent to the recording of my statements and do hereby irrevocably grant to Stephen F. Austin State University ("University") the right to copy, reproduce, and use all or a portion of the recorded interviews (the "Interview") conducted by __________________________ on __________________. I understand that the Interview will be deposited in the East Texas Research Center (ETRC) for the use of future scholars and may be used for any lawful purpose in all forms and media including but not limited to public presentations, audio or video documentaries, CD-ROMs, internet publications, slide-tape presentations, exhibits, and advertising and related promotion through the world in perpetuity, and expressly permit such use. This gift does not preclude any use that I myself may want to make of my words in these recordings to the extent it does not conflict with this agreement.

I release University and its assigns, licensees and successors from any claims that may arise regarding the use of the Interview including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity, or copyright. I acknowledge that I have no ownership rights in any work developed as a result of the Interview.

Restrictions: _______________________________________________________________________

I certify that I am over the age of eighteen (18), have read and fully understand the terms of this agreement.

Signature of Interviewee & Date:_____________________________________________________

Address of Interviewee: ____________________________________________________________

Contact Information of Interviewee:____________________________________________________