November 10 Confidentiality Form

Question Title

* 1. Please type your first and last name below.

Question Title

* 2. I agree to participate in today’s jury project by keeping an open mind, considering the evidence presented to me, discussing the facts of the case only during deliberations with my fellow jurors and deliberating in good faith until reaching a verdict.

I agree to keep all evidence presented to me as well as any and all discussions, deliberations and the verdict in strict confidence. I agree to be videotaped to keep a record of today’s proceedings. I understand that any information I provide will also be kept in strict confidence.

Please check whether you agree below:

I agree to the confidentiality agreement above.

I do not agree to the confidentiality agreement above and DO NOT wish to participate in this project.

Question Title

* 3. Please type your name below (as a means of signing this agreement electronically) if you agree to the confidentiality agreement above.

Question Title

* 4. Please put today's date below.

Date / Time

Date