Survivor Anthology Submission Form

Survivor Anthology Submission Form

Safe Passage is calling for submissions to our first ever Survivor Anthology, containing poetry, prose, photography, and other artwork submitted by survivors of domestic violence/relationship abuse in our community.
If you would like to talk through your story or submission, get feedback or assistance with formatting, review it with someone before submitting, or just talk about the process, you can contact our Anthology Team at anthology@safepass.org.

If you would like to connect with someone about your experience of domestic violence or relationship abuse, please reach out to our helpline at 413-586-5066, or toll-free at 888-345-5282. Our helpline is staffed Monday through Friday from 9am to 5pm.

**Please review the Submission Guidelines on our webpage carefully before submitting.**
Name:*

First NameLast Name
Note: Your real name will be kept in strict confidence unless you provide explicit consent to share it.
Name you would like to publish under: *
If the same as above, write N/A.
Email:*
example@example.com
Note: This email will be used to communicate with you throughout the submission process. Please make sure that you are using a safe email address.
Are you currently connected with Safe Passage?*

Current/former clientCurrent/former staffCurrent/former volunteer or internCurrent/former board memberCurrent/former donorI am not currently connected with Safe Passage.Other
(Optional) Identities that hold meaning for you:
i.e. gender, race, sexuality, ethnicity, ability, etc.
Please upload your submission(s) file:*

Cancelof
Title(s) of submission(s):*
If there are multiple pieces, please separate them by semi-colons (;).
I have read and understand the submission guidelines outlined above. I confirm that my submission meets the submission guidelines.*

Yes, I do.No, I do not.
I give Safe Passage staff/volunteers permission to review this work, as well as provide suggestions and edits.*

Yes, I do.No, I do not.
I give Safe Passage permission to utilize and repurpose parts or all of this work for promotional/outreach materials.*

Yes, I do.No, I do not.
I understand that I am submitting this work for publication that will be hosted on the Safe Passage website and accessible by the general public. I give Safe Passage permission to publish this work.*

Yes, I do.No, I do not.
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