Consent Form:

My name is Caleb Browning, and I am a Media Diploma Student at Long Road Sixth Form College. I am creating a documentary film that I would like to include you in. However, I have to get consent from you to be filmed via a consent form.

I, Vikki Browning agree to take part in the Diploma project stated above and may or may not be posted around the world. I have had the project and process explained to me of what the film is about and what is needed and I understand that agreeing to participate means you are willing to help me.

I understand that my participation is voluntary, that I can choose not to participate in a certain area of the project or all of the project, and that I can withdraw from the project at any stage.

I give my permission to be filmed, or have archive footage added in of by Caleb Browning for the use of a Media Diploma project.

Name: Vikki Browning

Signed:

Date: