WELCOME...YOUR VOICE IS VALUABLE
Parents all over the world are living their struggles, sufferings, and there victories behind closed doors. We believe that it is times for us to start a dialog that allows other parents to gleam from real stories that make parenting a group effort. A safe place where you are "no longer alone." 

Please answer the questions below then share your story. Let's be a voice to a silent community.  Please be as transparent as possible. We need to hear your struggles, sufferings, and victories. 
Email *
DATE *
MM
/
DD
/
YYYY
YOUR EMAIL ADDRESS? *
YOUR PHONE NUMBER? *
YOUR AGE? *
HAVE YOU EVER BEEN INTERVIEWED BEFORE? *
DO YOU KNOW HOW TO USE ZOOM? *
WHAT TIME OF DAY ARE YOU MOST AVAILABLE? *
Required
SHARE A LITTLE AB0UT YOURSELF, I.E.  Married or not married, how many children their ages, working or stay at home parent,  etc. *
GIVE AN OVERVIEW OF YOUR STORY... 
(Tell us a little about your childhood to adulthood experience, try to keep it brief. How did your parents, parent you? Did you feel prepared to raise children? What was your greatest challenge in raising your children?)
*
How would you say todays environment has fed into your families household. 
Clear selection
BE TRANSPARENT SHARE THE STRUGGLE IN YOUR STORY (give 3 points) *
BE TRANSPARENT SHARE THE SUFFERING IN YOUR STORY (give 3 points) *
BE TRANSPARENT SHARE THE VICTORY IN YOUR STORY (give 3 points) *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Justin L. Davis Foundation, Inc..