YPA Donor Deed of Gift Form and Release

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About This Form

The person being interviewed is the Narrator/Donor.

The person legally signing this form is the Signer. If the narrator is 18 or older, the narrator signs for themself. If the narrator is under 18, a parent or legal guardian must sign.

The person asking the interview questions is the Interviewer.

This form gives YPA permission to preserve and use the interview and related materials according to the agreement below. Please read the form carefully before signing.
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Narrator Name* This field is required.Name of the person being interviewed.
First Name
Last Name
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Narrator Pronouns Optional: Pronouns of the person being interviewed.
EXAMPLES: She/they; Ze/Hir; He/him
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Narrator EmailPlease provide a personal email address you are likely to keep over time. This email will not be shared publicly. It will be used only to contact you about permissions, access questions, or updates about how the oral history or related materials are used by YPA.
example@example.com
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What is your role in the interview?* This field is required.Select all that apply.
I am the narrator.
I am the interviewer.
I am the parent/legal guardian of a narrator under age 18.
Other
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Who is completing this form?* This field is required.Select one.
I am the narrator and I am 18 years old or older.
I am the parent/legal guardian of a narrator under 18.
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Narrator Date of Birth* This field is required.If you are under the age of 18, a parent/legal guardian must complete and sign the form.
Date
Month
Day
Year
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Parent/Legal Guardian NameRequired for narrators under the age of 18. The parent/legal guardian must sign the form.
First Name
Last Name
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Parent/Legal Guardian EmailPlease provide a personal email address you are likely to keep over time. This email will not be shared publicly. It will be used only to contact you about permissions, access questions, or updates about how the oral history or related materials are used by YPA.
example@example.com
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Interviewer Name* This field is required.Name of the person who is asking the questions.
First Name
Last Name
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Interview Date* This field is required.Year / Month / Day on which the interview occurred.
Date
Month
Day
Year
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Materials Covered by This Agreement

The materials covered by this agreement may include:

Audio and/or video recordings of the interview

Transcripts, captions, abstracts, summaries, field notes, descriptive essays, and catalog records

Photographs, still images, or video images of the narrator written materials, personal documents, or other items provided by the narrator or signer

Edited excerpts, oral history remixes, short audio documentaries, pocket films, or other works created from the interview
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Access Status

Please choose whether the interview and related materials may be made available without temporary restrictions, or whether temporary access restrictions should apply.

Unrestricted means YPA may make the interview and related materials available for archival, educational, scholarly, public, and programmatic purposes according to this agreement.

Restrictions apply means the signer is requesting a temporary limit on public access. If restrictions apply, you must provide either an end date or clear instructions for when the restriction may be removed. Restrictions do not apply during the current seminar/workshop. This means the interview and related materials may be made available without restrictions during the current seminar/workshop for which this interview/materials was produced.

YPA will not sell the interview or related materials to a third party. Personal contact information will not be shared publicly.
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Access Status:* This field is required.
Unrestricted: I do NOT wish to place any temporary restrictions on this interview or related materials.
Restrictions Apply: I wish to place temporary access restrictions on this interview or related materials until the date provided below.
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OPTIONAL: Temporary Access Restriction End Date and DetailsI wish to place the following temporary restrictions on public access to this interview, including the recorded audio/video and subsequent transcripts of the interview. My restriction includes both an END DATE and DESCRIPTION. I understand that if I do NOT enter an "end date," YPA is permitted to make the interview and related materials available for archival, educational, scholarly, public, and programmatic purposes according to this agreement. Enter the DATE when the temporary restriction should be removed, and DESCRIBE what should be restricted.
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Archive Access

YPA is currently administered by The Ed Factory, LLC, while a long-term repository is being identified. Access to YPA materials may be provided for archival, educational, scholarly, public, and programmatic purposes, according to this agreement and any access restrictions selected by the signer. YPA will not sell the interview or related materials to a third party. Personal contact information will not be shared publicly. If YPA is transferred to a future library, archive, museum, university, nonprofit, or other repository, that repository may preserve and provide access to the materials according to this agreement and any restrictions recorded here. Questions about access to YPA materials may be directed to: hello@youngpeoplesarchive.org.
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Agreement* This field is required.
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Required Signature of Narrator or Parent/Legal Guardian* This field is required.
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Please verify that you are human* This field is required.
Should be Empty: