Request edit access
This is a confidential form & will be used for the purposes discussed. Please DO NOT share with others, this is for your testimony only. This form only allows a paragraph. If you need more space, please complete a document for upload and return to the form when you are ready to submit. You are also able to submit images into this document. Once you submit you will not be able to view or change.
Name *
If you are not yet comfortable with giving your full legal name, you are more than welcome to use a pen name. But we will reach out to you for more when it's time.
Contact Information *
You can give us a phone number or email address. You are more than welcome to use a nondescript email address. Just give us one you check...
Born in the cult?
Select other if you just think it's not an easy answer
Date of Birth *
Number of half and whole siblings *
When did you leave the cult? *
Education Level *
What type of work did you do as a child? *
List the Countries you lived in *
Names & or Cities of the homes you lived in *
Do you have a document or images that you would like to submit into testimony?
List the Name (s) (legal/cult) of abusers
This document only accepts so many words. You may upload a longer document if you wish. Do you know the name of spouse(s) and children, nationality of the abuser? It would be easier to find legal names if there is a family history. Any details.
Do you know of any active TFI homes, leadership locations etc that you are willing to submit or discuss?
Impact Statement *
Please explain how your childhood, which was created by Zerby has impacted your reality up until now.
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