Tribal Consent Form
Review the project description and record your consent for the activity and uses described.
Consenting Person and Community
Consenting Person’s Full Name
*
First Name
Last Name
Tribal Nation or Community Name
*
Role or Relationship to the Community
*
Project or Activity
Project or Activity Title
*
Project or Activity Purpose and Overview
*
What Is Being Asked of the Person or Community
*
How Information, Materials, or Contributions Will Be Used or Shared
*
Contact and Consent Record
Contact email address
*
example@example.com
Consent declaration
*
I have reviewed the project description and agree to the specifically described activity and use of information or materials. My consent applies only to the described scope and does not grant broader permissions.
Consenting person’s signature
*
Submit
Submit
Should be Empty: