Request edit access
Healing Ink, Chicago
A select group of Chicago's most famous and talented artists providing free tattoos for those affected by gang violence and other violent crimes, including survivors and family members of victims. By so doing, we hope to help these individuals reclaim their bodies and find beauty and healing.
Full Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
I am a... *
Please tell us your 9/11 story
Your answer
Why do you want to participate in this program?
Your answer
Please describe general elements of the tattoo you would like to get, including size and location (note: all tattoos will be decided in collaboration with the Healing Ink team and the artist)
Your answer
Please describe the meaning and significance of your tattoo (note: the meaning does not have to related to the events of 9/11)
Your answer
Do You Have Other Tattoos
Would you be comfortable being tattooed at the Memorial?
Please confirm the following: *
Required
How did you hear of this program?
Your answer
Your E-mail Address *
Your answer
Your Phone Number *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Artists 4 Israel. Report Abuse - Terms of Service