What is your full name? (If published, your story will include only your first name, and only with your permission) *
What is your role in the education system? *
Please tell your story. *
If your story is published, do you want your first name included or would you rather remain anonymous? *
If you would like to include a photograph with your story, submit it to firstname.lastname@example.org. Please include your full name and email address as written on this submission form.
How did you hear about Start Healing Together? *
>> 1 << I give permission for Start Healing Together™ to share my story (in part or in full), my first name and photo (if my consent is given) on its website and/or all social media pages. >> 2 << I reserve the right to request for the post(s) to be taken down. >> 3 << I agree to notify Start Healing Together™ at email@example.com to submit a formal request for the removal of any aforementioned information. *
A copy of your responses will be emailed to the address you provided.