You must have JavaScript enabled to use this form. Your Name First Name Last Name Telephone Email My Story Brief Story or Topic you are comfortable sharing I would like to share my story by: Written Story Testimonial / Quote Photo Accompanied Story Artwork Video Story Public Speaking My Relationship to Ontario Shores - Select -Currently receiving services from Ontario ShoresReceived services from Ontario Shores within the past two yearsFamily member of someone receiving services at Ontario Shores Intended Audience(s) Other Patients - Internal Other Patients - External School Students General Public Family Members Ontario Shores Staff Mass Media - TV/Radio/Print Ontario Shores Foundation - For Fundraising Purposes Size of audience I am comfortable with for public speaking - None -1-56-1212-2525-5050-200200+ Time Availability I will need support developing my presentation and story You may contact me to invite me to join committees at Ontario Shores Leave this field blank
