Your story can be anywhere from a few paragraphs to a few pages (the more the merrier!). You can type or paste your response directly in the box below. *

What is your first and last name? (You will only be publicly identified by your initials) *

What is your age? (18+) *

What country were you born in? *

Which country are you in? *

Which state are you in?

What city are you in? *

What is your current employment status? *

What is your occupation? *

What is your annual household income? (in U.S. dollars) *

What is the highest degree or level of school you have completed? (If you’re currently enrolled in school, please indicate the highest degree you have received.) *

What is your marital status? *

How do you describe your gender identity? (Mark one answer) *

How do you describe your sexual orientation? (Mark one answer) *

Which of the following best represents your racial or ethnic heritage? (Choose all that apply) *

What is your e-mail address? *

What is your phone number?

Do you authorize Life in Quarantine: Witnessing Global Pandemic to contact you for further research purposes? *

Would you like to be considered to participate in the NoiseFilter podcast? *

Would you like to receive e-mail updates on this project? *

Please read the following terms applicable to all submissions to this project: I understand that Life in Quarantine: Witnessing Global Pandemic is preparing an online public access archive, which may be published in a non-profit format in the future. In order to assist in the preparation of the project, I have agreed to have my original submission published and/or displayed publicly and my biographical data incorporated into the project. I understand that material submitted through this form must not violate any security, privacy, confidentiality or other laws. I agree not to submit material that contains sensitive personal information about other people, including personal health information. I also certify that I am 18 years of age or older. I hereby grant to Stanford University and the project facilitators, and to any licensees, successors, and assigns of each: 1. The right to quote, paraphrase, reproduce, publish, distribute, or otherwise use all or any portion of my submission in any manner, form, or purpose and in any media throughout the world and in perpetuity. 2. The right to use my initials (and not legal name) and biographical data in connection with any use of the submission. 3. The right to change the names of individuals mentioned to initials in order to protect privacy. I hereby waive any right I may have to inspect or approve the use of my initials, biographical data, or submission as incorporated in the project, and acknowledge that I have no copyright, rights to remuneration, or other rights in the project. I hereby release and discharge Stanford University, the project facilitators, and any licensees, successors, and assigns of each, from any and all claims, demands, or causes of action that I may have against them regarding any use of my submission or regarding anything contained in the project or in related advertising or promotional materials, including (but not limited to) any claims based on the right to privacy, the right to publicity, copyright, libel, defamation, or any other right. By checking that I accept in the box below I am agreeing to the above and confirming my submission. *