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in a collection on our Digital Archive at https://fortfairfield.omeka.net/ Your email, address and phone number will NOT be published.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
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Address
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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:
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Digital Signature
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Type your full name to agree to the Digital Submission Terms and Conditions
Are you over 18 years of age?
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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:
Upload a File
Cancel
of
Artwork, Photos or Other Graphics:
Upload a File
Cancel
of
Other:
Browse Files
Cancel
of
Click here to Submit Information
DateTime
Should be Empty: