SayPro Ethical Storytelling Consent Form

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1. Participant Information

• Full Name:
• Age:
• Gender:
• Contact Information (Phone / Email):
• Location / Community:

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2. Purpose of Storytelling

I understand that SayPro seeks to collect personal stories, testimonials, photographs, or videos to raise awareness, promote empowerment, and support advocacy related to population development initiatives.

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3. Consent Statement

By signing this form, I hereby give SayPro permission to:

• Use my story, testimonial, image, and/or video for publication in SayPro’s magazines, reports, websites, social media, and other communication platforms.
• Edit or adapt the content as needed, with respect to the original context and message.
• Share my story with partners, donors, and other stakeholders involved in SayPro’s programs.

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4. Rights and Privacy

• I understand that my participation is voluntary and I can withdraw my consent at any time by contacting SayPro.
• I acknowledge that SayPro will respect my privacy and handle my personal information in accordance with applicable data protection laws.
• I may choose to remain anonymous or have identifying details withheld if I prefer.

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5. Consent Options (Please tick one):

☐ I consent to the use of my name and identifying information.
☐ I consent to the use of my story or image anonymously (no identifying information will be shared).
☐ I do NOT consent to the use of my story or image.

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6. Participant Declaration

I have read and understood the information above. I consent voluntarily to participate in SayPro’s storytelling initiative under the terms described.

Participant Signature: ____________________________
Date: ____________________________

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7. Consent Obtained By

• Name of SayPro Staff / Interviewer:
• Signature:
• Date: