Student
name: _____________________________
The
person you intend to interview (Full name): ___________________________
Date, time
and location of interview:
______________________________________
Have
you contacted the interviewee and have they agreed to sign the release form?
________
Did
you explain the purpose and use of this project? ________________________
Background
of interviewee
(occupation, age or
year of birth, education, religion, experiences, national born citizen, country
of origin, documents, photographs, artifacts, political and social memberships,
places lived and when, married, children)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Historical
period or event the interview will focus on and what was going on
(Historically--be detailed with dates)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Why
did you choose this interviewee and period of focus?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Preliminary
Works Consulted
List a minimum of three sources (text) you have accessed and that will
help in your historical contextualization (MLA format).
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Preliminary
Questions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________
Student's
signature date
________________________________ ___________
Teacher’s
signature date
approved/date