The "Beneath Our Skin" storytelling project is led by Clemmons Family Farm- a 501c3 nonprofit organization- and funded by the Vermont Department of Health. The project will collect stories from 50 providers and 100 Black Vermonters about their COVID-19 vaccination experiences. The goal of the project is to learn from the stories gathered in six counties around the state and use the insights gained to help the Vermont Department of Health improve its support to vaccination providers along with its vaccination services for Black Vermonters.

The purpose of this form is to identify providers who are interested in learning more about the "Beneath Our Skin" storytelling project and potentially signing up for a storytelling session with a trained artist. As a provider who might particiapte in this storytelling project, you would have the opportunity to meet in a fun, low-key and creative session facilitated by a trained artist who will help you to tell your COVID 19 vaccination story through an art form of your choice: either singing, music, poetry, or drawing.

We are interested in stories from people who have been fully vaccinated, partially vaccinated, or who have not been vaccinated at all against COVID-19.

You do not have to be artistic to participate in the storytelling sessions. Even people who have no special skills or experience with the arts can have fun trying them with a trained artist and using them to help share their stories. However, if you do not want to use an art form to help tell your story, you may simply tell your story without any art accompanying it.

Each storytelling session will be about 90 minutes. As a participant, you might either be in a one-on-one session with the artist, or you might be in a session with three other providers. For all of these sessions, all COVID 19 safety protocols and recommendations will be followed, including masking, spacing, and outdoor settings or settings with high ventilation.

Clemmons Family Farm will compensate you with a $200 participant stipend for your story and your art through a Paypal Transfer to your email address after you complete the session.

This form is a preliminary form for you to sign up as a provider who is interested in learning more about the project and possibly participating in the storytelling. Completing this form does not in any way commit you to continuing with the project and does not guarantee that you will be selected to participate in the project. Clemmons Family Farm will send you and other providers who sign up additional information about the date, time and venues of the storytelling sessions.

Your information will be kept confidential and will only be used to facilitate follow-on communication from Clemmons Family Farm to help you decide if you'd like to participate in a scheduled storytelling session with one of our artists.

Please complete the questions below and submit the form.

Thank you!