CHANGED Share your Story Submission Form

First Name *

Last Name *

Date of Birth *

Phone Number *

Email Address *

State/Country of Residence *

What was your life like before you pursued change in your sexuality? (Approx. 200-300 words) *

0/600

How did you feel about yourself before? How did you experience your masculinity or femininity before pursuing change? (Approx. 200-300 words) *

0/600

What precipitated the change (an experience with God, another person’s counsel, a book, a class, a sermon, reading the Bible etc.)? (200 words) *

0/600

When were you born again? (before, during or after identifying as LGBTQ)? (Approx. 200 words) *

0/600

How do you feel today? What is life like for you now? (Approx. 200-300 words) *

0/600

How do you currently experience your masculinity or femininity? What caused you to experience this differently? (Approx. 200-300 words) *

0/600

Indicate the period of time the transformation took (instantaneous, gradual, six years, etc.) *

How long have you been walking in your new reality as a son/daughter of God? (Specific date/year?) *

Please share a brief timeline of your journey from when you first started experiencing LGBTQ to present to ensure that we understand your experience clearly. *

What were the primary resources that were helpful in your journey and how did you find them? (Ex. Books, faith-based literature, training, paid support/therapy groups, counseling/therapy, pastoral ministry, curriculum, marriage/relational/purity seminars, conferences) *

Mentor/Pastor Full Name *

Mentor/Pastor Phone Number *

Mentor/Pastor Email *

May we feature your story on our website, social media accounts, and newsletter?*

Yes, pleaseNo, thank you

Would you like your ministry name and website to be featured with your story on our website?*

Yes, pleaseNo, thank you

Ministry Name

Ministry Website

Please submit up to 5 photos of yourself. Photos should have a high resolution and include: - Only you (no friends please). - "Before" and "After" photos (if you have them). Images must be separate, not collaged together. - Family members may be included, but please note uploading their photo means they agree to the Release Waiver. *

Our team will do our best to accurately represent you and your story based on your answers to the above questions. After drafting a written version of your story, we will email you a final version for your approval. You will have 7 days to approve or submit edits to your story at that time. If you do not submit approval or edits to the final version of your story within the allotted time, you are agreeing and authorizing Equipped To Love/CHANGED Movement to publish and use your story on their websites, social media accounts, newsletters, promotional materials, and all other forms of media.*

Yes, I agree to these termsNo, I do not agree to these terms

***Note: Not agreeing to the above terms and not responding within the allotted time will result in your story not being published until you've given consent. Our team will only reach out to you twice before we discontinue the publication process.

I hereby give my permission to Equipped to Love/CHANGED Movement (DBA's of Moral Revolution) and any associated organizations or contractors to photograph, videotape, record/write testimonies and/or otherwise make recordings of me (including name, face, likeness, appearance and/or voice) and use the images I submit for any legitimate use connected to Equipped to Love/CHANGED Movement without limitation or reservation. I understand that these images and recordings may be used for production, publishing, website material, media sources and in connection with social media, publicity, all forms of advertising, and promotional materials. I agree to relinquish to Equipped to Love/CHANGED Movement all right, title, financial remuneration and interest in the recordings and images. I further agree that I, on behalf of myself as well as my heirs, legal representatives, successors or assignees, will hold Equipped to Love/CHANGED Movement harmless from any and all liability and will never assert any claim against Equipped to Love/CHANGED Movement and/or the aforementioned arising from or out of the media productions, reproduction and/or use of the aforementioned media recordings and images. I have read the above and understand and agree to its contents.

Signature*

Date Signed *