Missouri Storytelling Project

Storyteller Interest Form
Who are we?

We are Tonal Range Media, working in conjunction with MODDC to create a Storytelling Project in the State of Missouri. We shall showcase stories of individuals with Intellectual/Developmental Disabilities that highlights the barriers that are present in social, medical and every day situations. These stories will be vital in not only bringing awareness and connection within the state of Missouri, but directly call for action and change on a systematic level.
Filling out this interest form does not guarantee that you will be selected to be interviewed or featured in this project.

Submissions Due June 1st, 2025
Name*

First NameLast Name
Preferred Pronouns
Missouri County of Residence*
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
EmailTextPhone call
I am the Storyteller and I have an Intellectual/Developmental DisabilityI am the Storyteller and I am a family member or caretaker of a person with I/DDI am assisting the Storyteller, who is diagnosed with an Intellectual/Developmental DisabilityOther
If other is selected, please expand:
YesNo
YesNoUndecided
Sign Language InterpreterSpanish InterpreterVisual AssistanceOther
If other is selected, please expand:
LGBTQIA+Poverty-LevelHispanic or Latino or Spanish OriginAmerican Indian or Alaskan NativeNative Hawaiian or Other Pacific IslanderBlack or African AmericanAsian
This storytelling project focuses on systematic barriers individuals diagnosed with Intellectual Disabilities and their families face. This includes instances in medical situations, job seeking, housing, and quality of life. What is a barrier that you or your loved ones have faced?*
Each story will show examples of self advocacy or emerging self advocacy. Please share an instance of self advocacy, such as a school project, participation in social clubs or activities, job success, or other accomplishment that you or your loved one has achieved. No accomplishment is too small *
We want to celebrate our Storytellers! Please share something you are proud of; a hobby, a passion or anything else you'd like to be featured in your story*
Anything you want to add?
Funding for Storytelling in Missouri is provided by the Missouri Developmental Disabilities Council, was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,361,246 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government

Submission of this interest form does not guarantee participation in this project
Please verify that you are human*
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Storyteller Interest Form

Who are we?