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US History Class Oral History Project Informed Consent
1. I agree to participate in an interview in connection with the Gavilan College California History Class Oral History Project. I understand that I will be asked about my life and experiences. Unless I consent to further use of the material, the work will only be used in class and on the anti-plagiarism website Turnitin.com as part of an oral history research assignment for the student’s grade.
2. The interview will be audio recorded. In the interview I will be identified by name, subject to my consent. I will also be identified by name in any transcript (whether verbatim or edited) or written report of such interview, subject to my consent.
3. I understand that the interview series will take a minimum of three hours, and that I can withdraw from the project at any time, though such a withdrawal could have a negative impact on the grade of the student involved. In the event that I withdraw from the interview after recordings are made, any audio recording made of the interview will be either given to me or destroyed, and no paper will be made available in any public media based on what I have shared.
4. Subject to the provisions of paragraph five below, I understand that, upon completion of the interview, IF I CONSENT at the end of the interview process by signing A DEED OF GIFT, separate from this INFORMED CONSENT, the audio recording and paper written by the student, its sole owner, could be shared by the student with the Gavilan College Oral History Archive and/or with one or more local historical organizations, and that subject to my consent, the information in paper or recording could be used by these entities in any manner it will determine, including, but not limited to, use by researchers in presentations and publications.
5. Gavilan College and the historical societies agree that: (i) they will not use or exercise any of its rights to the information in the interview prior to or in the absence of my signing of the deed of gift; (ii) the deed of gift will be submitted to me for my signature at completion of the interview; and (iii) restrictions on the use of the interview can be placed in the deed of gift and will be accepted as amending all organizations’ rights to the content of the interview. I understand that I have the right to review the audio recording or transcript of, or report on, the interview before I sign the deed of gift.
6. Any restrictions as to use of portions of the interview indicated by me also will be edited out of the student’s final report paper.
7. I understand that at the conclusion of this particular study and upon signing the deed of gift, the audio recording, and one copy of the student paper, will be kept by the Gavilan College Oral History Archive and/or local historical organization/s.
8. If I have questions about the research project or procedures, I know I can contact instructor Leah Halper at the Gavilan College History Department, 5055 Santa Teresa Blvd., Gilroy, CA 95020, phone (408) 848-4846, email
If I feel I have not been treated according to the descriptions in this form, or that my rights as a participant in research have been violated during the course of this project, I know I can contact Leah Halper for discussion of the problem.
____ I agree to be identified by name in any report based on this interview.
____ I wish to remain anonymous in any report pertaining to this interview. I wish to have the audio recording(s) containing my interview closed to use.
Interviewer signature______
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consent date __/__/__
Last updated: October 2015