Community Memoir Collection Project
Street, City/State, Zip Code
Cell Phone Number
Description - Please record your personal experiences and other historical accounts that you remember about growing up in Winston-Salem from 1940 - 1999. Be very explicit with descriptions and include dates, neighborhoods, locations, names, etc.
Required Signature - By participating in the Triad Cultural Arts Community Memoir Collection Project, each entrant understands that if her/his story, images, etc. is selected to publicy display, s/he will relinquish all claims, rights (including any moral rights), and benefits related to the display, modification, reproduction, publication, distribution, use, and other exploitations of the work. This form must accompany all submissions. Sign below.
Please sign your name with your cursor.
Please verify that you are human
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