Bowling Green State University

Dr. Louisa Ha College of Arts & Sciences Department of Telecommunications 322 West Hall Bowling Green, Ohio 43403 (419) 372-9103 phone (419) 372-9449 fax

TCOM103 Project Interview Consent Form

This interview is for the purpose of fulfilling the group project course requirement of TCOM103 Media/Information Society of Dr. Louisa Ha that I’m taking this semester. Our project is about _____________. Interviewing you will help me understand the project topic better with your insights and opinion. You can choose not to answer specific questions that I asked you. When signing this consent form, you indicated that you agree to participate in this project and allow me to record your opinion and comments for the purpose of this project. You have also been informed that you will be quoted in my project report.

Your decision to participate in this project is totally voluntary. Thank you very much for helping on this project.

If you have any questions about the interview or requirements of our group project, please contact Dr. Louisa Ha at 372-9103. If you have other concerns, you can contact the Chair of the Human Subjects Review Board, at 372-7716.

Sincerely

Student Name

I agree to be interviewed and read the consent form above.

________________ (Name in print)

_________________(Signature) ____________ (Date)