NGO Initiative Interview Consent Form
Please provide your details and consent to participate in the NGO initiative interview.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Email
Phone Call
Text Message
Other
Please select your preferred interview date and time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
How would you prefer to participate in the interview?
*
In person
Online (video call)
Phone call
May we record your interview (audio and/or video) for documentation purposes?
*
Yes, I consent to audio and video recording.
Yes, audio recording only.
No, I do not consent to any recording.
How can we use your interview responses?
*
Use my responses anonymously in reports or publications.
Use my name and responses publicly (e.g., website, social media).
Contact me for follow-up questions or clarification.
Other (please specify)
If you have any accessibility needs or special requests for the interview, please let us know.
Signature (please sign below to confirm your consent)
*
Submit Consent
Submit Consent
Should be Empty: