ࡱ> /J.k DbjbjZ Z .8cb8cb6 fffffzzz8 z0fhhhhhh$Vfff4&&& fff&f&&&Û&R0&#N#&#f&,&@#B ,: Deed of Gift Materials Release Form for Interviews, Oral Histories, or other Audio/Video Recordings During the interview(s), you were recorded on audio and/or videotape so that your information may be preserved as an historical record/ used in a classroom presentation (please make this appropriate for your study). Upon completion of the interview, the interviewer compiled the recording into a written transcript. Having read the transcript of the interview, you have three choices regarding the audiotape, videotape, and/or transcript of the interview. The materials may be designated either public, for research only, or private. If you designate the materials public, the audiotape(s), videotape(s), and/or transcript(s) will be accessible to members of the community through the (Facility that will receive the materials, this should be as specific as possible). The (Facility) may use the materials from the interview(s) for future exhibits and your materials will remain part of its permanent collection. If you designate the materials for research only, your audiotape(s), videotape(s), and/or transcript(s) will be analyzed by the researcher and your information will be used to complete the research study. Your information will be reported in a way that does not identify you and your materials will be destroyed after the study is complete. If you designate the materials private, the audiotape(s), videotape(s), and/or transcript(s) will be given to you and never released to the (Facility). The only records of the interview will belong solely to you. If in the future you wish to change the status of your audiotape(s), videotape(s), and/or transcript(s), you may contact the (Facility): Include the full address and contact information of the facility here. ___ I hereby designate the materials as public and give permission for my audiotape(s), videotape(s), and/or transcript(s) to be used by the (Facility). ___ I hereby designate the audiotape(s), videotape(s), and/or transcript(s) for research only and give my permission for the researcher to use my materials as part of the research study. I want my materials to be reported so that they will not identify me and destroyed when the study is complete. ___ I hereby designate these materials as private and do NOT give my permission for my audiotape(s), videotape(s), and/or transcript(s) to be used by the (Facility). The materials will be given to you for your own private use. Signature: ______________________________________________ Date:_________________ You will receive a copy of this form for your records.     d ; < U ^ _ t w  m t ~  3 j w b)/bjl5679:<=?@CDзззззh0]jh0]UhiA,he=OJQJhiA,hiA,CJaJhiA,6CJOJQJaJhiA,CJOJQJaJhiA,hiA,6CJOJQJaJhiA,hiA,CJOJQJaJhiA,hiA,5CJOJQJaJ: d X 0689;<>?ABC dgdiA,gdiA, gdiA, $ a$gdiA,CD gdiA,,1h/ =!"#$%  s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH66666666666666666666666666666666666666666666666666666666666666666p62&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ OJPJQJ_HmH nH sH tH J`J Normal dCJ_HaJmH sH tH d@d iA, Heading 3$ d@&5CJOJPJQJ\^JaJDA D Default Paragraph FontRiR 0 Table Normal4 l4a (k ( 0No List R/R iA,Heading 3 Char5CJOJPJQJ\^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< D  D CD @ @H 0(  0(  B S  ?E <M4pxR Y { 6 E 3333333333 cc<<lmmu}~~WW//b l 5 E 5 6 8 9 ; < > ? A E iA,e=0]Ypu66 8 @D @UnknownG.[x Times New Roman5Symbol3. .[x Arial7..{$ CalibriA$BCambria Math"hGG!01 1 KQIP  $PiA,2!xx  Loeb, Laura Loeb, Laura Oh+'0t  0 < HT\dl Loeb, Laura Normal.dotm Loeb, Laura2Microsoft Office Word@@@ ՜.+,D՜.+,` px  Loyola University Chicago Document1   Title0ContentTypeId$_ip_UnifiedCompliancePolicyUIAction&_ip_UnifiedCompliancePolicyProperties,0x0101007545DC5D634C134AB6CC2D27085E83B9  !"#$%'()*+,-01O3456789:;<=>?@ABCDEFGHILMNRoot Entry F8K1Table#WordDocument .SummaryInformation(DocumentSummaryInformation8&MsoDataStore`'ÛIWGZOUO4DCPCQ==2 `'Item 20/PropertiesPBKLU1FYWEFWQ==2 `'ÛItem  PropertiesO This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision.   DocumentLibraryFormDocumentLibraryFormDocumentLibraryForm   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89qCompObjr