Home . CiviCRM. Storyteller Form. . Telling your story - our agreement Thank you so much for considering telling your story at a Touch storytelling celebration event. Please read our 'Important Information and Guidelines for Speakers' document before completing this form. First Name * Last Name * Email address * Street Address * Supplemental Address 1 * Supplemental Address 2 * County - select State/Province - Aberdeen City Aberdeenshire Angus Antrim and Newtownabbey Ards and North Down Argyll and Bute Armagh City, Banbridge and Craigavon Bedfordshire Belfast Berkshire Blaenau Gwent Bridgend Bristol, City of Buckinghamshire Caerphilly Cambridgeshire Cardiff Carmarthenshire Causeway Coast and Glens Ceredigion Cheshire Clackmannanshire Clwyd Co Antrim Co Armagh Co Down Co Fermanagh Co Londonderry Co Tyrone Conwy Cornwall County Durham Cumbria Denbighshire Derbyshire Derry City and Strabane Devon Dorset Dumfries and Galloway Dundee City East Ayrshire East Dunbartonshire East Lothian East Renfrewshire East Riding of Yorkshire East Sussex Edinburgh, City of Essex Falkirk Fermanagh and Omagh Fife Flintshire Glasgow City Gloucestershire Greater Manchester Gwynedd Hampshire Herefordshire Hertfordshire Highland Inverclyde Isle of Anglesey Isle of Wight Kent Lancashire Leicestershire Lincolnshire Lisburn and Castlereagh London Merseyside Merthyr Tydfil Mid and East Antrim Mid Ulster Midlothian Monmouthshire Moray Na h-Eileanan Siar Neath Port Talbot Newport Newry, Mourne and Down Norfolk North Ayrshire North Lanarkshire North Yorkshire Northamptonshire Northumberland Nottinghamshire Oldham Omagh Orkney Islands Oxfordshire Pembrokeshire Perth and Kinross Powys Renfrewshire Rhondda, Cynon, Taff Rutland Scottish Borders Shetland Islands Shropshire Somerset South Ayrshire South Glamorgan South Gloucestershire South Lanarkshire South Yorkshire Staffordshire Stirling Suffolk Surrey Swansea Torfaen Tyne and Wear Vale of Glamorgan, The Warwickshire West Dunbartonshire West Glamorgan West Lothian West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Wrexham Postal Code * Phone number * I understand the event is a public event and will be attended by anyone booking a ticket. * Yes No I understand that Touch Network CIC cannot guarantee my story will be kept confidential between those attending the event. * Yes No I understand that the event may be photographed or filmed for publicity purposes. * Yes No I understand that my first name only may be used for publicity prior to the event, together with a couple of sentences summarising my story. * Yes No I would like to join your mailing list and understand that I can unsubscribe at any time. * Yes No I agree to adhere to the Storytelling Guidelines outlined in the "Important Information and Guidelines for Speakers" document, namely: Hopeful, not depressing; Story, not sermon; Sharing, not teaching / ranting; 'I', not 'you': * Yes No Save