Move Minnesota Stories Submission & Consent Form

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Minnesota's transportation system affects people every day. By sharing your own experience and perspective, you can help Move Minnesota fight for the changes that matter most to you.

Submit your story below! Please send a good quality photo and/or video that we can use with your story to: zet@movemn.org. Thank you so much!

Tell us about your experience with transportation in your community. How has this impacted you? *

Why does improving transit, bicycling, walking, or rolling matter to you? *

What are your hopes for the future? *

Would you be interested in sharing your perspective with elected officials or other decision-makers? If so, Move Minnesota can help. *

Yes

Maybe

Required

I grant Move Minnesota and any of their agents and assignees permission to use my name and likeness, including photographic, video, and audio recordings, without payment or other consideration as they see fit. Move Minnesota may publish, distribute, exhibit, and edit these materials, in perpetuity, for the purposes of marketing, publicity, advertising, education, and news production. *

Yes

Required

First and Last Name *

Email *

Street Address

City *

State *

Other:

Required

Zip Code *

Phone number *

Signature *

Date Signed *

YYYY

I am 18 years of age or older *

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