Telling Your StoryGraduate Team Please take a moment to fill out the following information about your involvement with ACTS. Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Please note the below questions are a guide. You may feel free to share with us in any format what you are comfortable with. How did you first hear about ACTS? Why did you choose ACTS rather than a different organization? Please tell us about the process of applying for and receiving your ACTS dog. What would you say to someone considering applying for a dog through ACTS? How has your relationship with your ACTS dog influenced your life? How has your ACTS dog changed your life or the lives of others around you? Is there anything else you would like to share? Are you willing to have ACTS share your story with local print publications? * Yes No Would you be willing to have ACTS share your story and photos and/or videos on our social media platforms and website? * Yes No Are you interested in sharing your story on a live and/or pre-recored television interview? * Yes No Are you interested in sharing your story on the radio? * Yes No By returning this form to ACTS, you are authorizing the organization to contact the media on your behalf, and you are agreeing to speak with the press as a volunteer/spokesperson in our efforts to tell our story. We will write and submit press releases to the media for you, create social media content, and we may utilize your story in our brand collateral including website, brochures, and other media. *Please note we are unable to guarantee that your story will appear in print or in other mediums. Thank you!
