একতারা

Participation / Consent Form

If you are an artist, craftsperson or knowledge-holder taking part in the Ektara research, please complete this form. You may also download and complete it on paper.

About you

Artist / participant name *

Father’s name *

Date of birth *

Age

Gender

Blood group

Current profession

Educational / institutional affiliation

Photo and identification

Passport-size photo

A recent passport-size photo. JPG, PNG or WebP, up to 100 KB — a larger photo is made smaller for you.

Choose a photo

National ID (NID) number

10, 13 or 17 digits.

Passport number

As printed on the passport, e.g. A01234567.

Your practice

Stream of art practice

Folk instrument / folk song expertise and experience

Training subject

Special skills

Preferred art / music discipline

Portfolio links

Where your work can be seen or heard — YouTube, Facebook, SoundCloud, a website. Up to ten.

Address and contact

Division *

District *

Upazila / Thana *

For a city thana such as Dhanmondi or Panchlaish, choose “Other — not listed” in the list above.

Thana or area name *

Address

Village or area, road, house.

Contact

Consent

I hereby certify that I give my informed consent to the use of my personal identity, photographs, audio and video documentation, interviews, instruments, and my involvement in this research, together with the necessary information and data. I also wish the Ektara research every success.

I have read the statement above and give my consent.

Signature / thumbprint

Sign with your mouse, trackpad or finger.

I certify that the participant has been informed, as clearly as possible, of the purpose of this research, the nature of their participation, and the potential use of the information and records collected.

What we do with this information is set out in our Privacy statement. You may ask us to delete your response at any time.