Operation-365 Interview Survey

First Name*
Surname (optional)
E-mail
Gender*

MaleFemale
Age Range*

Under 1818 to 2425 to 3535 to 4445 to 5455 to 6465 and over
Country*
State*
City, Township, Village, Etc.*
If you had the stage and all the world were listening. What words of wisdom, council or advice would you share?
Looking ahead, as far or as close as you want to imagine (one year or hundreds of years). What do you think we should do now to better the future?
Upload Photo

Upload a File
We invite you to submit a photo of yourself, your neighborhood, city, town, village or country. Cancelof
To keep us all safe, we need to know that you are a real person and not a Robot.

Please Enter The Message As It Is Shown, Then Press The Submit Button.
By submitting I give my permission to Operation-365 to use my video, written word, audio, music, photographs and first name for the sole purpose of non-commercial presentation and publication, including but not limited to, blog, streaming and social media and networks, website, art shows, exhibits, collectors books, editorial use and Operation-365 presentations and portfolios. I do not grant Operation-365 permission to use my name or photographs for the purpose of endorsing goods and services, other than those directly related to Operation-365, without further written consent from both parties. I have obtained all required releases and premissions for all persons, logos, product, locations or materials appearing in my submitted video, and hold Operation-365 harmless for any and all release or copyright infringement resulting from all persons, logos, products, locations or materials appearing in my submitted video.
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