Parental Consent Form for Minor Interviews

This form is required to obtain parental/guardian consent for the participation of a minor in an interview.

Minor's Information

Full Name

Date of Birth

Address

Full Name

Relationship to Minor

Phone Number Email

Purpose of Interview Date and Time Location Interviewer(s)

I, the parent/legal guardian of the above-named minor, hereby consent to their participation in the interview described above.

I permit the use of the minor's interview material for publication and/or research purposes.

Parent/Guardian Signature

Date

Interviewer Signature

Date