carrie outhier banks

I understand that I must VERBALLY state on the videofile and audiofile whether I would like the video to remain private or if it can be added to the webpage. Please consider your privacy carefully and choose what is right for you and your family. *

I understand

Current Occupation (home maker, mother, doctor, realtor, etc) *

Confirm Age Eligibility *

Yes - I am over 18.

Email:

Thank you for sharing your story.

It will make a difference.

CLICK HERE
for the
Consent
Agreement

For which project are you submitting? *

Teen Book (assault/abuse happened when I was in HS or college)

Adult Book

Audifile from vonaroo.com

I will be submitting *

Written

Audiofile - if audiofile, please complete this form and email file to carrie@carriebanks.com

Videofile - if video, please complete this form and email file to carrie@carriebanks.com

Age (or age span) when the abuse/assault occurred. *

By checking yes below, I am certifying that I agree with the Submission Guidelines and Consent Agreement (click the buttons below to review again) *

Yes

Upload your story here (Word or Google.doc forms appreciated for the written. If you would like to send a video or audiofile, you may do so here as well):

Welcome to the submission form. I'm honored you are here, and I look forward to reading, hearing or watching your story.

If this is your first time visiting, please visit the Story Guidelines Page, which will answer many of your questions about subject matter, length, and style. Following our guidelines will give me the best possible chance of being able to use your story.

It is my policy to keep your personal information strictly confidential. It will NOT be sold, traded or used for any other purpose than to communicate with you regarding Carrie Outhier Banks's products and programs.

I prefer that you submit your stories only once, submitting the SAME story more than once to the SAME topic causes delays, so please resist the urge to submit your story multiple times to the same topic. Feel free to submit NEW stories under DIFFERENT topics, I know that many stories cover many different topics.

Thank you so much for sharing your story to help others.

CLICK HERE
for
Submission
Guidelines

* indicates a required field

Current age: *

First Name (real or fake), State in which you live AND any random 5 digit number (for file sorting)- if video or audifile, please use the same real or fake name, state and number in your emails so that I can match them up with this consent form *