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How is COVID-19 impacting you?
Down Home North Carolina is made up of people like you and your story matters.

As COVID-19 exposes the social and economic crises that our communities have long endured, it is important that we get the stories and real-life experiences of poor and working class North Carolinians in front of the media, legislators, and the public.

Responses to this survey may be quoted in Down Home publications. You may chose if you wish to be anonymous. If you are willing to share your story and thoughts with the media or on the Down Home blog, we will reach out to you.

Questions? Email Gwen Frisbie-Fulton at gwen@downhomenc.org 
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What is your name? *
May we use your name publicly? *
Where do you live? *
How should we contact you? *
Please leave contact details: *
In what ways has COVID-19 impacted you personally? Check all that apply. *
Pflichtfrage
Can you tell us a little bit more about your situation? *
If you could tell your local lawmakers one thing about COVID-19, what would it be? What would you like to see them do to help communities like yours? *
Is there anything else you would like to share about COVID-19 and its impacts on your community?
Down Home is working with local journalists and other organizations to publish stories like yours. Would you feel comfortable working further with Down Home to share your story? Check all that apply. *
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