Your Story

Thank you for helping us by sharing your story! Use the form below to share your experience with CDC. To help bring your story to life, you can add photos or a video or request our Communications Team to film your story for you.

Let's begin...

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

NAME*

First name Last name

Email address*

Phone*

Best times to contact you

Current job title

Place of emploment

Please tell us where you are today and how CDC positively impacted your life.

What county was your center in?

Please list your center's name.

What program were you in?

Visuals help show impact. Please upload a recent professional photo and a photo of you as a child.

If you have recorded yourself telling your story, please upload this as well.

Max. file size: 256 MB.

If you would prefer CDC to record you telling your story, please pick two dates that you could record.

Did you know there are other ways to give?

Your Story

Let's begin...

Select an age to begin!