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Stories from a Distance - Submission Form

Thank you for helping to document the COVID-19 pandemic in Madison. This is the form to fill out to share an image and a written response to it.

The image should be something that relates to your experience of the COVID-19 pandemic, while schools and many businesses are closed, and while we are social-distancing.

The written response can be about the image - a poem, a song, a caption, a few sentences, or a longer piece.

Image
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Response
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png txt rtf pdf doc docx odt.
Parent / Legal Guardian Info
Because either the artist or writer is younger than 18, a parent/legal guardian needs to grant permission and verify with an email address.
First and Last Name
Comments / Contact
Agreement
Please select an option.

Thank you for sharing your story! Please complete the form by clicking "Submit" below.

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.