INTERVIEW WAIVER

I, the undersigned, hereby acknowledge that I have voluntarily agreed to be interviewed by $,$ a student of Sprott Shaw College. I understand that my comments may be shared with the student's instructor and$/$or classmates as part of a learning activity. I also understand that, if I am uncomfortable with any question$($s$),$ then I may excuse myself from answering it$/$them$.$ Furthermore, I understand that every effort will be made to protect my privacy by the elimination of details that would identify me$,$ such as the use of my name in the presentation.

Participant Name $($Print$)$

Witness Name $($Print$)$

Signature

Signature

Student Project: once signed, please give this directly to your instructor. Forms must be signed prior to the interview with the above participant.