Submissions for Hearing Voices: Writings from the Circle Name * First Name Last Name Please indicate how you would like to be identified from the following choices: (first name only, first name + last initial, initials only, no name attached) Age (Optional - However if you include age, it will be used along with any identifying name or initials provided.) Year (Optional - If you would like to include the year you wrote this piece, please list it here.) Email * Writing Submission * Affiliated Organization (the facility where you may have written this piece or participated in the Writing Circle with Scott.) Site names will not be identified with your name if your writing is posted here. If you prefer not to identify the organization, please check the appropriate line below: ARC Bench Mark Program Blueprints for Addiction Recovery Colonial House Concern Domestic Violence Services Gate House Men Gate House Women Gaudenzia program Lancaster County Youth Intervention Center Manos House SCI Camphill Vantage House White Deer Run Youth Development Center of York I prefer not to identify the affiliated organization. Other Affiliated Organization if not listed above: Terms & Conditions * Not all submissions can be posted. Please be aware that this site may be viewed by all ages. By checking this box, you acknowledge that your writing may be edited for graphic language and/or graphic content and that you give permission for this piece to be edited and posted on this site. Additionally, you give permission for your submission to be used in any print format that may feature writings on this site. First names or initials only will be used with writings, along with your age or the year if you choose to offer this additional information. I understand and accept these terms + conditions Thank you!
