Bluegrass Survivors Council Registration Form

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At Ampersand, we believe that using your voice and your power can be a tool for healing and we want to create spaces and funnel resources to survivor led projects and build a community that listens to survivors. That is why we are so excited to launch the Bluegrass Survivors Council.

The Bluegrass Survivors Council will be informed by its members and will utilize the empowerment model. We are here to lend support for survivors to connect, to be heard and to build a space within our work. There are already individuals who have experienced sexual violence contributing at all levels at Ampersand, but this is a space to nurture survivor leadership throughout our community.

Complete this form and we will be in touch about what is to come!

Email *

Name *

Pronouns *

Phone Number *

Birthday *

YYYY

Do you identify as a survivor of sexual violence? *

Yes

Are you committed to combating rape culture and elevating survivor voices? *

Heck yeah!

I don't know what some of those phrases mean, but probably!

This doesn't sound like what I'm interested in.

What is inspiring you to join the Survivors Council? *

What has helped you get to where you are in your healing journey? *

Send me a copy of my responses.

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