Report Your Positive Story Basic InformationLocation (where it happened): *Office - local or state gov'tOffice - federal gov'tPublic buildingClassroomHotelApartmentShelterPlace of WorshipPublic meetingOn the streetStore, mall, etcBarPublic parkRestaurantHospital / Doctor's officeOther If 'Other', please briefly describe City or Town where it happened: * State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Date it happened *Exact date is not necessary, please give an approximate date. Who was involved (strangers, co-workers, boss, etc)? In Your Words: what happened, what it meant to youDescribe your positive experience Be sure to include: - the action(s) by or words of others - how it (they) felt to you - where it happened - who witnessed it - what, if anything, resulted from it - has anything like this happened before? if so, over what period of time has this happened? What Happened About YouThis story is about a positive experience by: *MyselfSomeone Else May we contact you? It may be helpful to our work if we can ask you a few questions about your story. All contact and identity information will be kept in the strictest confidence and will not be used for ANY other purpose. I am willing to be contacted by MTPC via the means I am supplying here:Name Email * Phone Weekdays, do NOT call before: 010203040506070809101112HH000510152025303540455055MMAMPMAM/PM Weekdays, do NOT call after: 010203040506070809101112HH000510152025303540455055MMAMPMAM/PM It is OK to leave a voice message from MTPC: YesNo Comments VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank Share this:FacebookTwitterGooglePrintMoreTumblrLinkedInPinterest