SARS-Cov-2 Community Impact Submission

SARS-Cov-2 (Covid-19) Community Impact Submission Form

Fort Fairfield Public Library is collecting and preserving community archives of stories, photos, videos and documents of your life during the Covid-19 pandemic.
Use the form below to submit your stories that convey your thoughts, fears, joys and sadness during Covid-19 in 2020. Stories will be collected and preserved in a collection on our Digital Archive at https://fortfairfield.omeka.net/ Your email, address and phone number will NOT be published. This is only contact information if we have any questions about your submission.
Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail *
Phone Number *

Area Code Phone Number
Date Submitted *
Digital Submissions Terms and Conditions
Please choose one of the following and sign below: *
Digital Signature *
Type your full name to agree to the Digital Submission Terms and Conditions
Are you over 18 years of age? *

Yes No
Parent or Guardian

Please read and sign below
Parent/Guardian Full Name *
Child's Full Name *

First Name Last Name
Child's Age *
Digital Signature *
Type your full name to agree to the Digital Submission Terms and Conditions
Type your story and upload your files here:
Your story (or attach and submit files below)
Text file:
Artwork, Photos or Other Graphics:
Other:

Browse Files

Cancel of
DateTime
Should be Empty:

Parent or Guardian