ANNEX C: INTERVIEW CONSENT FORM TEMPLATE
INTERVIEW CONSENT FORM
DFA Social Media Campaign: “The Global Filipino”
The Office of Strategic Communications and Research of the Department of Foreign Affairs (DFA
OSCR), through the Philippine Embassy in New Zealand , wishes to use for promotional purposes
your photographs/video and interview answers for the social media campaign “The Global Filipino”.
‘These photos/video and interview responses may appear on the following official social media
accounts of the DFA:
Facebook: www.facebook.com/dfaphi
Twitter : www.twitter.com/DFAPHL
Instagram: www.instagram.com/dfaphl
Information other than the photos/video and quotes collected from the interview will not be published
on the abovementioned social media accounts of the DFA. Nevertheless, please take note that the
photolvideo, and quote/s uploaded on the Department's Facebook, Twitter, and Instagram accounts
can be seen throughout the world, not just in the Philippines.
Conditions of use:
‘+ DFA OSCR will not use your photos/video and interview answers for any other purposes
than those already mentioned.
‘+ Except for the name of the interviewee and his/her city or town of residence, DFA OSCR
will not include other personal details of the interviewee (e.g., exact home and office
address, contact numbers) in the social media posts for the campaian.
'* Copyright of photos/video taken by the Philippine Embassy in New Zealand will remain with
DFA OSCR.
(Note: If the interviewee is below 18 years old, this form must be filled out by the interviewee's
parent or legal guardian.)
DO YOU GIVE US PERMISSION TO USE YOUR PHOTOSIVIDEO AND QUOTES FOR THE
DFA’S SOCIAL MEDIA CAMPAIGN “THE GLOBAL FILIPINO"?
YES No
Name of interviewee (or parent/guardian of the interviewee):
(if applicable) Name of parent/guardian of the interviewee:
Signature: Dat
(or of the interviewee’s parentiguardian)