Confidentiality Agreement-English

CONFIDENTIALITY AGREEMENT
I hereby agree to keep confidential all information discussed during the Focus Group in
which I am participating in {location} on {date}, being conducted by Annapolis
Professional Resources, Inc. on behalf of the USDA, Food and Nutrition Service. I
understand that my comments will be kept confidential and used only for research
purposes. My name will not be divulged in any report.
_________________________________________
Signature of Participant

________________________
Date

_________________________________________
Name of Participant

Annapolis Professional Resources, Inc. hereby agrees to keep confidential all information
discussed during the Focus Group held in {location} on {date}, on behalf of the USDA,
Food and Nutrition Service.
_________________________________________
Signature of Authorized Personnel

________________________
Date

_________________________________________
Name of Authorized Personnel

{Name of Local Agency or Research Facility} hereby agrees to keep confidential all
information discussed during the Focus Group held in {location} on {date}, on behalf of
the USDA, Food and Nutrition Service, Supplemental Food Programs Division.
_________________________________________
Signature of Authorized Personnel
_________________________________________
Name of Authorized Personnel

________________________
Date