Sample Oral History Consent Form

Before conducting an oral history interview, make sure to create a consent form for you and your interviewee to sign. Use the printable version below as a template for creating one for your archive or project.

Download the printable template below.

[Name of the Repository or Archival Project (e.g. Wilson Special Collections Library)] 

Informed Consent and Copyright Permission 

This document explains how your oral history interview and materials may be used and stored; it describes what participants can expect from their items being scanned, and when signed; it acts as a copyright permission and informed consent form. It is the mission of [the repository] to [mission statement]. 

I, ___________________________________, voluntarily agree to share with [the repository/project] my oral history interview and [list of materials]. I understand that I am free to decline to answer any questions that make me uncomfortable or to stop the interview at any time. 

I understand that the following items may be created from an interview and materials I share: edited transcripts and summaries; edited audio/video clips; copies in whole or in parts of any photographs and personal documents shared. 

I hereby give permission to [the repository] to use my interviews and other items listed above in all forms and media for [the repository]; including but not limited to use whole or in part in exhibitions, public programs, documentary films, radio broadcasts, and publications in all formats and media, including on the Internet.   

I hereby freely share the Material with [the repository] under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. This means that I retain the copyright to the Material, but that the public may freely copy, modify, and share these items for non-commercial purposes under the same terms if they include original source information. I reserve the right to submit a written request to end this agreement.  

I further understand that I will have the opportunity to review and edit a transcript of my interview before it is made available. I understand that [the repository] may choose to accession some or all materials into another institutional repository now or in the future, and I consent to this transfer and use of materials.  

INTERVIEWEE’S FULL NAME (PRINT): ______________________________________________ 

INTERVIEWEE’S ADDRESS: _______________________________________________________ 

INTERVIEWEE’S EMAIL: _______________________________________________________

INTERVIEWEE’S SIGNATURE:  _______________________________________    DATE: ___________ 

INTERVIEWER’S NAME (PRINT):  ______________________________________________

INTERVIEWER’S EMAIL OR PHONE #: _____________________________________________

INTERVIEWER’S SIGNATURE:  _________________________________________    DATE: ___________


REPRESENTATIVE’S NAME (PRINT): _________________________________________________________ 

REPRESENTATIVE’S SIGNATURE: _________________________________________________________

DATE: _____________________