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Undergraduate Life-Story Research

INTERVIEW CONSENT FORM


[Date]

Dear [Interview Participant],

I am an undergraduate student at the University of South Florida-Sarasota-Manatee. For my academic


writing course (ENC 3310), I am conducting an undergraduate research project. Key components of my
study are three interviews with a community member, each lasting at least 45 minutes. I have selected
you as a potential interviewee for my research project, should you agree to participate.

If you permit me to conduct three interviews with you about your life, I will ask you several questions
about your personal experiences, which you may elect not to answer. I will take written notes on your
responses to my questions. Depending on the consent that you provide below, I may also audio-record
the interviews. If you consent to be audio-recorded, you may request that the recording be stopped or
resumed at any time during the interviews. No one but I will have access to the interview notes and/or
audio recordings. Moreover, I will destroy any audio recordings of the interviews at the end of my course
(ENC 3310). In addition, your identity will be protected by a pseudonym in my course work and in my
interactions with my classmates and course instructor.

My undergraduate research project is solely for educational purposes. Outside of my academic writing
course (ENC 3310), I will not publish or otherwise disseminate any of my work for this research project.
Please feel free to contact my course instructor, Dr. Ann Lawrence, if you have any questions or concerns
regarding my research project:

Dr. Ann Lawrence


Instructor of English and Composition, Composition Coordinator
College of Liberal Arts and Social Sciences
University of South Florida--Sarasota-Manatee
8350 N. Tamiami Trail, C263
Sarasota, FL 34243-2025, USA
annlawrence@sar.usf.edu
(941)359-4226

Below is an interview consent form that asks for specific permission to interview you and to audio-record
the three interviews. Please indicate "Yes" or "No" for each item on the list, and return the form to me.
Thank you for considering this possibility.

Sincerely,

[Students Name]
[Students Mailing Address]
[Students E-mail Address]
[Students Phone Number]

Written Consent to Be Interviewed


I give my written consent to be interviewed three times Yes_____ No_____
for at least 45 minutes each time.

I give my written consent to be audio-recorded during the interviews. Yes_____ No_____

Date:

Name:

Contact Information:

Signature: