Northwestern College
RELEASE FORM for ORAL INTERVIEW

for
HIS240 The Sixties
Dr. Doug Anderson, Instructor

I, _________________________ (the interviewee), understand that the interview I am giving is for the purpose of _________________________ (the interviewer) learning about one individual’s experience of "The Sixties" in order to learn how to understand that experience in light of the larger situations and developments of the time.

Therefore, I _________________________ (the interviewee), hereby release any written notes, written transcript, and/or sound recording made of the interview with me on __________ (date of interview). _________________________ (the interviewer) may use any said notes, transcript, and/or recording for assigned course work in HIS 240, The Sixties and deposit a copy of said notes, transcript, and/or recording with the course’s instructor. Such deposited material is understood to be in partial fulfillment of the course’s requirements. Such deposited material is not intended for general public use; any such use will need the oral or written permission of the interviewee or her or his legal representative or heir.

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Signature of Interviewee & Date

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Signature of Interviewer & Date