Interview Registration

Please read the Disclaimer below.

Disclaimer

This is a free, non-profit project with no commercial gain. All interviews, whether written or video, are conducted on a voluntary basis. The purpose of this project is educational, historical, and entertainment-focused. The project seeks to preserve stories and insights for archival purposes.

The primary scope of the project is Lakeside Mall, a currently-closed, soon-to-be demolished, commercial and cultural icon.

However, we extend our scope to and encourage discussion of any shopping mall in the Detroit area or any in the State of Michigan.

Please read the Privacy Notice below.

Privacy Notice

1. The intent of this project is to collect the minimum necessary details for survey use and inclusion in a video documentary. Details may include: Questionnaire Responses, and Personal Information.

2. Personal Information: If you wish to remain private or anonymous, you are within your right to do so. You are doing a great favor to this project. You should mind your best interests before helping others.

3. Contact Information: responses which shall be private and never public. This project will require at least one (1) response.

4. Definitions of key words:

• "anonymous": any Questionnaire Responses that you specify to remain disconnected from all Personal Information.

• "private": any Personal Information that you specify to remain disconnected from any or all Questionnaire Responses.

• "Contact Information": a telephone number, an email address, and/or a social network user name.

• "Personal Information": first name, age, and/or sex.

• "Questionnaire Responses": responses to questions.

Are you an adult (18 years of age or older)? Select yes or no.

If yes, skip to the next section.

If no, please provide two (2) statements, a Parental or Guardian Consent Statement, and a Child Assent Statement, in the following upload fields. If neither statement is provided, this registration will be discarded.

If you are not an adult, please provide a Parental or Guardian Consent Statement.

Parental or Guardian Consent Statement

I am the parent/legal guardian of the child named below. I understand that my child is being asked to participate in a research survey and/or video documentary. I have read and understand the nature of the project, including what information will be collected: first name, age, sex, and responses to questions.

I understand that:

• Participation is entirely voluntary.
• My child’s participation may be included in a public video documentary.
• I may withdraw my consent at any time without penalty.

Note: if you are viewing this as a paper document or as a PDF file, and do not see the signature box below, please do the following:

1. If possible: sign in the freespace below, but above the Date box (below).
2. Scan and reupload the document and forward as a direct message to any one of our contacts.
   1. Email us at projectlakesidemall@gmail.com.

If you are not an adult, please provide a Child Assent Statement.

Child Assent Statement

Please read the following aloud:

"I’m being asked to take part in a project where I’ll answer questions and maybe appear in a video. I can say yes or no. If I say yes now, I can still stop anytime. No one will be upset if I say no or stop later."

Note: if you are viewing this as a paper document or as a PDF file, and do not see the signature box below, please do the following:

1. If possible: sign in the freespace below, but above the Date box (below).
2. Scan and reupload the document and forward as a direct message to any one of our contacts.
   1. Email us at projectlakesidemall@gmail.com.

Please provide Contact Information for at least one (1) of the following fields.

Please allow for flexibility, should your preferred location be unavailable.

For example: Lakeside Mall is scheduled for demolition beginning end-of-year 2025. Only one (1) anchor store remains open and accessible as of writing (August 28, 2025).

Public and safe places are recommended.

Things to consider:

• Please allow for a one (1) week notice.
• You may schedule for up to four (4) weeks in the future.
• Please schedule between morning and evening.
• Interviews may be fast or slow, depending on the number of questions asked.
• If you wish to request an exception to any above rule, please don't hesitate to note this below in the Notes and/or Special Accomodations area below.
  
  

If you are viewing this form as a PDF file, please enter your schedule below under Calendar for PDF version. Please honor the above considerations.

If you are viewing this form as a web page, please enter your schedule below under Calendar for Web version.