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History of the
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Interview with

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Join us in recognizing the role of golf in Worthington

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                    <text>WORTHINGTON HISTORICAL SOCIETY
ORAL HISTORY PROGRAM
INTERVIEW LEADER

DATE::

ZCJL)t92LL

NARRATOR: JARED Jf52uA

LocATloN: TApttG?oM , 5ENA FArR,t^Biz£WatzY
INTERVIEWE:F2S:

k=ATf i=J^/£4L+D

TOplc (IF AppLlcABLE:):

Gttzj&gt;winq ixp ftl wotrt+]i^4Tz&gt;H + TDEc;\Tt&gt; `hJ€ |t7 stay

NARRATOR'S BACKGROUND
BOFiN

WHERE: WOQffl/N4fipN
WHE:N: 07JUL 19GqCAME TO WORTHINGTON

WEE:N. 3 4fu€ftyi ctos

�wORTHiNGTON HlsTORlcAi. soclE:ry
ORAL HISTORY PROGRAM
INTE:RVIE:W CONSE:NT AND RELEASE F-OHM

My signature below confirms my agreement with the Worthington Historical Society
(WITS) regarding the release of recordings as well as transcripts of interviews with me.

I agree to have my interviews recorded and to have a written transcription of the
interviews prepared. I have the right to edit the written transcript (if one is prepared) and
recording for spelling and grammar. I agree that corrections will be returned to the WHS
within 60 days of receipt of transcript and/or recording.
I understand that the WHS will make copies of transcripts and recordings for the WHS
Archive and for researoh and educational goals as the WHS shall determine. The WHS
will provide me with a copy of the interview recording and a copy of the transcript (if one
is made). Apart from specific restrictions listed below, I hereby grant and transfer to the
WHS all rights,' title and interest in the interview, including literary rights and copyright.
Finally, I permit the WHS to list my name as an interviewee for publicity and
fundraising/grant-writing purposes.

NAME(PRINTED):

G~TAR El`

ADDREss:

tuFFI`NG`T?rd

`s~q

PHONENUMBERts):

EMAiL

SEk\ Ac

I+,I.LL a.D.

L( l`-8C}Co -2GZT

js€rng s€^qTQT^ brflrfrj `cOz~\

I wish to place the following restrictions on my transcript and/or recording and name
release:

SIGNATUF3E: OF-INTEFivIEWE:E::

SIGNATUF3E OF. WHS FIE:PRESENTATIVE:
F?ETUF{N TO:

Worthington Historical Society
P.O. Box 12, 6 Williamsburg Road
Worthington, MA 01098 0012

DATE:

C76JLJA)2J

�</text>
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