Interview Release Form
KHOJAWIKI.org Family History Project
INTERVIEW RELEASE FORM
Date:________________________________________ Time:_________________________
Interviewer: ________________________________________________________________________________
Intervier number:________________________________________
Name of person(s) interviewed: ________________________________________________________________________________
Address: ________________________________________________________________________________
Telephone number:________________________________________
Date of birth:________________________________________
By signing the form below, you acknowledge that KhojaWiki.org is a non-profit organisation that is in the process of recording the personal and family histories of members of the Khoja community and that you give your permission for any recording and/or photographs made during this project to be used by KhojaWiki.org to publish on their global website as well as to release to researchers and the public for educational purposes including publications, exhibitions and presentations. By giving your permission, you do not give up any copyright or performance rights that you may hold. I agree to the uses of these materials described above, except for any restrictions, noted below.
Name (please print): ________________________________________________________________________________
Signature: ________________________________________________________________________________
Date:________________________________________
Interviewer’s signature: ________________________________________________________________________________
Date:________________________________________
