Thank you for taking the time to share your story with us.
Your story can inspire others to either make a change in their own lives or support our mission to empower children and families living in Guilford County.Please complete and submit the following story submission form.
If you have any questions, please contact Jim West at (336) 369-5008 or email@example.com.
(*) = Required Field
First Name: (*)
Last Name: (*)
(kept confidential) (format: 555-555-1234)
First Name(s) and Age(s) of Child(ren)
Which program are you (or were you) enrolled in?
How did you hear about us?
There are no right or wrong answers to the following questions.
You may provide as much detail as you wish. There is no limit to the number of characters you can type into the fields.
Please describe your childhood (see example below).
relationship with parents, relationship with brothers and sisters, living conditions, preschool environment, play time, best and worst memories, dreams of the future, etc.
Please describe your (and/or your child's) situation before entering the program (see example below).
your child's challenges, your relationship with parents, relationship with spouse/boyfriend, school life, pregnancy and/or parenting challenges, home life, support from parents, difficult times, how you felt about yourself, goals, dreams, what made you want to start the program, etc.)
What challenges/difficulties have you (and/or your child) faced during the course of the program
and how did you (or how will you) overcome them?
Please describe how you and your child(ren) have changed since you started
or completed the program. What has the program meant to you? What do you
see for the future?
Please add any additional information that will help us tell your story.
Upload a Photo
If possible, please upload a photo of you and your child(ren).
(*) Permission for Use
(form can't be submitted unless box is checked)
Enter Security Code and Click "Submit" (prevents spam)
Click here to change the code if difficult to read