Share your story with the media

Have you been personally touched by motor neurone disease? Do you have a story that you’re eager to share?

During MND Week (5–11 May 2013) we invite you to help raise awareness about MND by telling your story. We’re interested in stories from all angles – from the frustration and sadness of living with MND to accounts that inspire and capture the spirit of living.

Together with the state MND associations we’ll be working hard to promote stories for TV, radio and newspaper.  We are also interested in shorter stories, images, snippets and words of inspiration that are suitable for our new website and social media.

To register to share your story please complete the form below or email  iwanttotellmystory@mnd.asn.au
First Name  *
Last Name  *
Email  *
Phone
Mobile phone number
The suburb you live in  *
State or Territory  *
Your age group:  *
 less than 39
 40 to 50
 51 to 60
 Over 61
Please specify your connection to MND    *
Tell us a little about yourself  *
Tell us how MND has impacted your life
I am willing to be interviewed by the media for:
 print
 radio
 TV
I would like my story and/or image to appear on MND Australia's new website:
 yes
 no
I would like my story to be shared via MND Australia's:
 Facebook page
 Twitter account
I hereby authorise MND Australia to use the information provided above for media purposes:  *
 yes
 no

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