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pdfPARTICIPANT DATA SHEET
StoryCorps
collects information from every participant to ensure that our archive fully represents people of
StoryCorps collects information from every participant to ensure that our archive fully represents people of all backgrounds. For children
all
backgrounds
beliefs.
encourage
answer
asguardian
many of
questions
asinformation
you can,you
but
all fields
are
13 years old or under,and
this Data
SheetWe
must
be completedyou
by a to
parent
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the child. All
provide
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optional.
We dooptional
not sell
form is completely
andparticipant
will be subjectinformation.
to StoryCorps Privacy Policy. (https://archive.storycorps.org/privacy-policy/)
PERSONAL INFORMATION
Relationship: I am my interview partner’s
Title:
Name:
Address:
City:
State:
Phone number: (
Zip/Postal code:
Country:
)
E-mail:
Date of Birth:
month
/
day
/
City of Birth:
year
State of Birth:
Country of Birth:
DEMOGRAPHIC SURVEY
Race/Ethnicity:
(check all that apply)
American Indian or Alaska Native
Asian
Black/African American
Hispanic or Latino/Latina
Native Hawaiian
or Other Pacific Islander
White/Caucasian
(please specify)
We encourage you to use this space to describe your identity in your own words:
STORYCORPS USE ONLY (do not write in this section)
Initiatives:
Griot
Date of Interview:
Military Voices
Historias
Time of Interview:
OutLoud
September 11th
Location of Interview:
Memory Loss
Facilitator:
3.2017
4.2020
File Type | application/pdf |
File Title | Datasheet_2020_04.pdf |
File Modified | 2021-02-12 |
File Created | 2020-11-05 |