Share Your Story with The Mother PAC

Personal stories are critical when advocating for the policies that Oregon families need. By sharing your story, you can play a significant role in the work we do.

There are many levels of comfort when sharing one's personal story. Please share what you are willing, and indicate your permission levels where applicable. Please note: In sharing your story, keep in mind that your story — including your name if you provide it — may appear in public advocacy projects such as The Mother PAC websites, brochures, or other printed material. Even if you do not provide your name, keep in mind that some information can reveal who you are, such as unusual details about you or others. Information shared here is used solely for advocacy work and should only be shared voluntarily.

We will follow up to thank you and discuss next steps!

Email address *

Name

Your answer

Email address *

Your answer

Phone number

Your answer

Street address

Your answer

City, State, ZIP code *

Providing this information allows us to share constituent stories with the lawmakers who represent them

Your answer

Your story *

Your answer

Permissions: please check ALL that apply

Yes, I give permission to The Mother PAC to use my story or any portion of it in any manner or media for any lawful purpose whatsoever. I confirm that I have written the story myself, and I release Family Forward from any liability arising out of the use of my story.

Yes, I give permission to The Mother PAC to publish my first name, last initial, and city with my story.

Yes, I give permission to The Mother PAC staff to contact me about using my story using the contact information I have provided.

I certify that I am over the age of 18 and agree to the above

I certify that I am the parent or guardian of the minor participant named above and I agree to the above on behalf of the minor and myself.

Are you interested in getting involved in our work?

YES! I'm interested in volunteer opportunities with The Mother PAC.

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