Social Distance Photo Project

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Social Distance 4x5 project questionnaire - I am working on a project inspired by our current situation. I would like to swing past your home or someplace were we able to social distance the required amount to take your photograph.
I am planning on shooting 4x5 black and white as well as some digital photos. In conjunction, I would like to learn about your experience and attach it to the photograph. The text will be anonymous, meaning I will not be pairing up stories with images.

The initial plan for the project is an exhibit and a book where most of the proceeds will to a charity to support those who have been severely affected by the pandemic.

If you do not want your portrait taken, you can still fill out the form (even as anonymous). The text may be used in my project. As I create, I will keep you posted on my progress and plans.

Best,
Charulata

What is your name? phone number and or address? *

What was your initial feeling about the Pandemic as it started, before it got worse? *

What are your feelings about the pandemic now? *

What was the worst realization or thing that happened to you during this time? (can be more than 1 thing) *

What was the best realization or thing that happened to you during this time? (can be more than 1 thing) *

In what ways have you been surviving the lock-down? *

What are some things you took for granted before the lockdown? *

What is the first thing you are going to do when the lockdown is over? *

What are some things you plan on doing after the lockdown that you have never done before? (life changes, new hobbies, etc) *

Please use this section to add anything else? Your story, a poem, rant---anything to express what this experience has been like for you. *

Do you have any recommendations of organizations connected to the pandemic that proceeds can go to? *

Do you hereby agree to allow, me, Charulata L. Dyal to use this information as well as your portrait that has or will be taken by me in conjunction with the project for any fine art and commercial purposes? *

Yes, I grant you, Charulata Dyal, permission to use this information on this form as well as my portrait taken by her to be used in your fine art project as well as any commercial projects you may have. I do understand that the text will remain anonymous and not paired with the photo.

Yes, I grant you permission to use my photo and not my text.

I dont want a portrait taken but I did fill out the form for you to use in your project.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms