Your Name
Phone
Email
Who is this story about?
Community / City
Province
How would you prefer to share your story?
I would like to write my story below
I would prefer someone to call me
A short memory or reflection
Your story
Do you have photos you would be comfortable sharing?
Upload your file
Choose a file or drag and drop one here.
Upload Photos
Is there anything you do not want included publicly?
By submitting, I confirm I have permission to share this photo and information, and consent to the ALS Society NB&NS using it for the 40 Faces Wall, digital gallery, social media, marketing, campaign/event displays, and follow-up.
I have read and agree to the consent statement above.
Share My Story
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