RELEASE FORM

I, __________________________________ (name of narrator), hereby give this interview recorded on ___________________ (insert date) to the _______________________________(name of repository) as a donation. With this gift, I transfer to the ______________________________(repository) legal title and all literary rights, including copyright.

I understand the interview may be made available for research and such public programming as the ___________________________(repository) may determine. This may include use of the interview material in live or recorded programs for radio, television, cable, or any electronic publishing that is not for profit.

Narrator’s Signature____________________________________________________

Address______________________________________________________________

City, State, ZIP________________________________________________________

Date______________________

Interviewer’s Signature__________________________________________________

Address______________________________________________________________

City, State, ZIP________________________________________________________

Date_____________________

Comments: