My story: the 2020 COVID-19 pandemic
The COVID-19 pandemic is something that most people have not experienced in their lifetime. While there are many news reports, we would like to capture the personal stories about what is happening in the lives of our community.

Help us create a shared memory of this time. Your stories will become a part of the a permanent archival collection being documented by the White Pine District Library. This will give scholars, historians and medical researchers a record to study in the future.

Instructions:
-Most questions are optional, answer what you’re comfortable with
-Personally identifying information (such as your name, email, place of work) will be kept private until 2092.
-If you'd like to share images, audio or video contact us (see below)

Questions? Contact us at whitepinelibrary1@hotmail.com or aawillmore110100@gmail.com
Sign in to Google to save your progress. Learn more
I am at least eighteen years of age (if under the age of eighteen, consent must be signed by parent/guardian). I understand and agree that any information I share will become part of the archives of the White Pine District Library and will be available to and shared with the public. * *
Required
I agree to freely share my story under the terms of a Creative Commons Attribution-NonCommercial ShareAlike 3.0 Unported License. This means that I retain the copyright to my material, but the public may freely copy, modify, and share these items for noncommercial purposes under the same terms, if they include the original source information. *
Required
What is your email (optional)?
What is your name? *
What is your zipcode? *
What neighborhood do you live in?
How old are you? *
What is your gender?
What is your race or ethnicity?
What is your occupation or profession?
Which of the following have you experienced as a result of COVID-19 since March 10, 2020? (check all that apply) *If you experienced these things for other reasons, do not check the box
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy