Testimonials

Name

First Name

Last Name

Phone (optional)

(###)

###

####

Please check all that apply: *

I am a program participant.

I am a volunteer.

I am a donor.

Would you be willing to come in and share your story on camera?

Yes

Maybe, I’d like more details

No, I prefer to share my story in writing

Which of OPEN M’s services or programs have you used or been involved in?

Pantry Services

Clinic Services

Employment Services

"Is it okay if we share your testimonial to help spread the word about OPEN M?"

Yes, and you can include my name.

Yes, but please keep my name private.