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Form · Oral history

Oral History Information and Consent Form

To be read to the narrator, or given to them to read, before the interview. The narrator gives or withholds each permission separately; nothing is published beyond the permissions given.

This is a translation for information purposes. The Turkish text is legally binding.

To use this form

Download PDF (ready to print)Download Word (.docx)

You can print the PDF, fill it in by hand and sign it, or fill in the Word file on a computer and print it. Send a photo or scan of the signed form by email together with your contribution.

What is this interview for?

mezirme.com is a non-profit website that records the history and culture of Mezirme (Ballıkaya) together with their sources, and it is run by MEZTECH LLC. In the interview you will be asked to describe, in your own words, your memories of the village and what you know about it.

  • The interview may be recorded as audio (or, if you allow it, as video) and transcribed.
  • What you say is written down without correction, in your own words; it is published on the site as an “oral account”, with your name (or the form of name you prefer) and the date of the interview.
  • You may decline to answer any question you do not wish to answer, and you may stop the interview at any moment.
  • You may ask to see the text before it is published. Even after publication, you may ask for it to be removed at any time.
  • No fee is paid for the interview, and no fee is asked of you.

1. Narrator

Full name
Year of birth (optional)
Connection to the village (optional)
Phone / address

2. Interview

Date and place
Collected by (interviewer)
Type of recording

3. Permissions

  • To an audio recording being made of the interview YesNo
  • To a video recording being made YesNo
  • To my account being transcribed and published on mezirme.com YesNo
  • To the audio recording being published on the site so that it can be listened to YesNo
  • To my photograph being published together with the account YesNo
  • I would like to see the text before it is published YesNo

My name alongside the account (tick one):

  • Give my full name
  • Give only my first name and the initial of my surname
  • Do not give my name; write something like “a narrator from Ballıkaya”

4. Personal data and explicit consent

The Data Protection Notice under the Turkish Personal Data Protection Law No. 6698 (KVKK) has been read to me / I have read it. I know that my account may include special categories of information, such as religion, denomination or health, relating to me or to others. I state my explicit consent separately on each of the following matters. I know that I may withdraw my consent at any time.

  1. To the publication of my name, my optional details and my account in the manner I have permitted above YesNo
  2. To the processing and publication of special categories of personal data about me, such as religion, denomination or health, that appear in my account YesNo
  3. To the processing of the recordings and my personal data on the servers of netcup GmbH (Germany), where the site is hosted, and on the servers of the email service provider (Google) abroad. I have been informed that the level of protection in these countries may differ from that in Türkiye, and of the risks this entails. YesNo

If other people are named in the account, the collector removes or anonymises hurtful or private information about living persons before publication.

Narrator

Full name
Signature

For narrators who cannot read the form themselves

I have read this form aloud to the narrator, and the narrator has given their permissions of their own free will and with understanding.

Reader’s full name / signature
Witness’s full name / signature

Collector

Full name
Signature

Withdrawal of consent

The narrator or their legal heirs may withdraw the permissions given by writing tomezirme@meztech.llc or by applying in writing to 112 Capitol Trail, Suite A, Newark, Delaware, USA. In that case the account and recordings are removed from publication.