Share your story with United Way of Anchorage

BACKLIGHTS: Stories Illuminating Community Challenges

United Way of Anchorage supports solutions that ensure every community member can have opportunities to thrive. People’s experiences inform our work. We want to hear how barriers or challenges to education, financial stability and health have affected you. By submitting this form, you’re letting us know you’re interested in allowing us to share your story to help advance positive change in our community. We appreciate the time you’re taking to complete this form. We respect your responses and will keep them confidential unless you approve of us sharing them. Everyone who submits this form will be contacted by someone from United Way’s Marketing and Communications team.

Your name(Required)

Please tell us your preferred first name.

Your pronouns

Please use the dropdown arrow to select your preferred pronouns.

Your email address(Required)

Please tell us your preferred email address.

Your phone number

Please tell us your preferred phone number, including the area code.

How did you learn about our storytelling project?(Required)

Please select the places or people that brought our storytelling project to your attention.

Have you ever shared a story publicly before?(Required)

We’re honored that you’re sharing your experiences with us. We respect your responses and will keep them confidential unless you approve of us sharing them. Our project intends to shed light on common challenges in our community. By exposing them, we believe we’re better able to address them. How? First, our project will unify people. We’ll see that we’re not alone and many of our neighbors are navigating similar challenges. Second, our project will provide hope. We’ll be inspired to come together to find solutions to our community’s challenges. Third, our project will bring change. When we Unite, we’ll improve our community so that everyone can have opportunities to thrive. Sharing your story publicly is brave, and our team of storytelling experts will work with you. You’ll be able to ask questions, let us know what you’re comfortable with and review anything we share publicly before it comes out. Please use the dropdown arrow to select the option that best applies to you.

Which type of stories could we feature you in?(Required)

Consider how comfortable you are with other people knowing about you, what you think and what you’ve experienced. Also consider how comfortable you are with having pictures or videos of you on the internet.

Why are you sharing your story with us?

You’re taking the time to complete this form for reasons that are unique to you. Please tell us what they are.

What area of Anchorage do you live in?(Required)

Please use the dropdown arrow to select the location that best describes what area of Anchorage you live in.

When have you lived in Anchorage?(Required)

Please use the dropdown arrow to select the option that best describes you. For this question, “Anchorage” is considered to be anywhere in the “Anchorage area.”

How many people are in your household?(Required)

Please use the dropdown arrow to select the option that identifies how many people you consider to be your dependents.

How are you connected to the people who are in your household?

Please select the options that tell us how you are connected to the people who are in your household. These people do not have to be your dependents.

Do you feel like your household lives paycheck to paycheck?(Required)

Please use the dropdown arrow to select the option that shows how you feel about you or your household’s earnings compared to your bills and expenses.

Have you ever lived in a household that has been at or below the poverty level?

Please use the dropdown arrow to select the option that best describes your experience.

How many hours per week are you working now?

Please use the dropdown arrow to select the option that best describes you. If you are a contract or seasonal worker, please estimate how many hours you work each week when you are working.

How many hours per week do you want to work?

Please use the dropdown arrow to select the option that best describes how many hours you want to work each week. If you are a contract or seasonal worker, please estimate how many hours you want to work each week when you are working.

How many jobs are you working now?

Please use the dropdown arrow to select the option that best describes you and includes self-employment, if it applies.

What is keeping you from working the hours or jobs you want?(Required)

Please select the options that are preventing you now from working what you want to work.

Do you have health insurance?

Please select the type of coverage you have.

I have private health insurance through my employer.

I have private health insurance through a family member’s employer.

I have private health insurance through the marketplace.

I have Medicaid or Denali KidCare.

I have Medicare.

I don’t have health insurance right now.

Other

Prefer not to answer

Have you recently gone without health insurance?

Please use the dropdown arrow to select the option that best applies to you.

What type of challenges are you experiencing now?(Required)

Please select the challenges that you are currently experiencing, regardless of your income, hours worked per week or the number of jobs you hold.

How long have you been experiencing these challenges?

Please use the dropdown arrow to select the range that tells us how long you have experienced these challenges. If several ranges apply, pick the one that matches what you consider to be your biggest challenge.

How confident are you these challenges will resolve?(Required)

Please use the dropdown arrow to select the option that indicates if you feel your challenges can be resolved.

What counts as your "network of support?"(Required)

Please select the options that tell us who or what you feel you can count on for help. They make up your “network of support.”

How confident are you in your "network of support?"(Required)

Please use the dropdown arrow to select the option that indicates how you feel about your “network of support.”

Share with us what's on your mind.

We invite you to tell us anything else you want us to know.

What is your age range?

Please use the dropdown arrow to select the range that best describes you.

What is your race and/or ethnicity?

Please select the options that best describe you.

Alaska Native

Asian

Black or African American

Native American or American Indian

Native Hawaiian

Pacific Islander

White

Other

Prefer not to answer

What is your highest level of education?

Please use the dropdown arrow to select the option that best describes you.

How do you consider yourself to be connected to United Way of Anchorage?

Please tell us about your connection to United Way.

I support you now.

I’ve supported you before.

My workplace has run a Community Campaign.

I work at a nonprofit in Anchorage.

A nonprofit in Anchorage has helped me.

I’m familiar with United Way.

I’m not familiar with United Way.

Other

Prefer not to answer

Disclaimer(Required)

By submitting this form, you are acknowledging that we (United Way of Anchorage) are receiving your responses. We will keep them while completing our storytelling project, and they will remain confidential. Our Marketing and Communications team will review submitted responses and follow-up with every submitter. We will not use any of the information in your responses in any public communications without speaking to you first and receiving your approval. Submitting this form does not guarantee your story will be included in our storytelling project. When we follow-up with you, we will notify you if we would like to use none, part or all of your story and will work with you accordingly.

Yes

Storytelling project submission form

BACKLIGHTS: Stories Illuminating Community Challenges

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