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Many examples are attached. In addition you can see examples from India and Tanzania.

File NameCountryLanguageDescription
CHW Contract - IndiaIndiaEnglishSimple agreement to sign. Main text:

"I receive the Nokia 2730 phone along with the charger for the use of protocols on the field and will return it back after completion of the pilot project. I take the responsibility of the proper use of the phone and charger for the time period of the pilot."

CHW Contract - India (Hindi)IndiaHindiSame as above, in Hindi
CHW Contract - TanzaniaTanzaniaEnglishMore detailed agreement outlining rules for ownership, usage, maintenance/credit, and what to do about lost/stolen/broken phones
Contract with the ASHAs_sampleIndiaEnglishSimilar to above but tailored for ASHAs in India
Entrega del telefonoNicaraguaSpanishSimilar to the "CHW Contract - India" file but in Spanish
Final Contract for CHEW telephone - PI NigeriaNigeriaEnglishSimilar to "CHW Contract - Tanzania"