Personal Contact Information

* 1. It's a question many survivors of dire circumstances ask; especially if someone has said, "You should write a book." Even though the seed has been planted, you may not yet be ready to write a book, or, if you are, know where to begin. By completing this questionnaire, and in as much detail as possible, you and I will explore your next steps. If you have any questions that aren't covered, there is a place at the end to ask them or to share any comments you may have.

Enter your full name, postal address, and phone number. I value your privacy. This information will not be shared or sold with anyone.