(a) I, _______________________________ , do
hereby give to the Missouri Historical
Society, except to the extent as modified by paragraph
(c) below, any material made,
drawn, or used in conjunction with the interview conducted
by a representative of the
Missouri Historical Society on [date] _________________,
including but not limited to the tape-
recorded interview and any photographs.
(b) The Missouri Historical Society may use
all of the above material for such scholarly
and educational uses as it shall determine. I donate
this material to the Missouri
Historical Society as an unrestricted gift and transfer
of legal title and all literary and
graphic property rights and exhibit rights, including
copyright. This gift does not
preclude any use which I may want to make of the taped
information or of the images
myself.
(c) The foregoing gift is subject to the following
restriction(s):
This agreement may be revised
or amended by mutual consent of the parties undersigned.
Interviewer signature: ____________________________________, Missouri Historical Society
Date __________________
Interviewee signature: ____________________________________
Date __________________
Interviewee address and telephone number: ____________________________________
_________________________________________________________________________