Manual
APPENDIX VIII
RESEARCH AGREEMENT
Freedom of Information and Protection of Privacy Act
This agreement is made between
| Name of researcher (referred to hereinafter as the
"Researcher") and ---------------------------Name
of institution (referred to below as the
"Institution")
|
| The researcher has requested access to the following
records containing personal information in the custody or the
control of the institution:
|
The researcher understands and promises to abide by the following terms and conditions:
1. The researcher will not use the information in the records for any purpose other than the following research purpose unless
the researcher has the institution's written authorization to do so: (Describe the research purpose below).
2. The researcher will give access to personal information in a form in which the individual to whom it relates can be identified
only to the following persons: (Name the persons below)
3. Before disclosing personal information to persons mentioned above, the researcher will enter into an agreement with those
persons to ensure that they will not disclose it to any other person.
4. The researcher will keep the information in a physically secure location to which access is given only to the researcher and to
the persons mentioned above.
5. The researcher will destroy all individual identifiers in the information by _______________. (date)
6. The researcher will not contact any individual to whom personal information relates, directly or indirectly without the prior
written authority of the institution.
7. The researcher will ensure that no personal information will be used or disclosed in a form in which the individual to whom it
relates can be identified without the written authority of the institution.
8. The researcher will notify the institution in writing immediately upon becoming aware that any of the conditions set out in this
agreement have been breached.
Signed at , this Day of 19
| Researcher's Signature |
Representative of Institution |
| Name of Researcher |
Name and Position of Representative |
| Address |
Name of Institution |
| Address |
|
Tel.no. |
|
Tel.no. |
|
OCIPO 
