Healing Through Art Gallery Submissions
About the Artist
Name (Optional)
First Name
Last Name
Email (Optional)
example@example.com
Phone Number (Optional)
Please enter a valid phone number.
Format: (000) 000-0000.
School or Organization (Optional)
About the Art
Type of Art
*
Painting
Sculptures
Drawing
Poem
Song
Other
Title of Art Piece
*
Share a message of hope for survivors (this message will be displayed with the artwork)
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Would you like your name to be displayed with your artwork?
*
Yes, I would like my name to be displayed with the artwork
No, I would like to remain anonymous
Maybe, I would like time to think about it
Are you interested in speaking about your artwork at the event?
Yes
No
Other
I give permission for my artwork to be printed and included in the event booklet.
*
Yes
No
Other
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DISCLAIMER: Please be aware that if you are under 18, are an individual with a disability, or are elderly, and you disclose personal experiences of violence or abuse, we are legally required to report this information to law enforcement authorities. Your safety and well-being are our top priorities, and this reporting obligation is in place to ensure that appropriate support and protection can be provided. If you have concerns or questions about this policy, please contact teendv.sddvc@gmail.com for further clarification before sharing sensitive information.
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I understand
I would like to receive an email with information about domestic violence resources available in San Diego County.
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I would like information about healthy relationship workshops
Other
Please share your email below if you would like to receive resources
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