Share Your Story

By: Source: AARP.org Date Posted: 2005-03-01 10:57:26

AARP Ohio is collecting personal stories of why in-home care is important to you or your loved one and sending them to your state legislators. Submit your story today.

AARP Ohio is collecting personal stories of why in-home care is important to you or your loved one. All stories will be collected and sent to your state legislators to show them why they need to adequately fund in-home care. Selected stories will appear on the AARP Ohio website.

In order to make sure your story is sent to your state legislators, the following address information is required. Your address information will not be used by AARP for any purpose other than locating your state representative and state senator districts. Your state legislators will receive a copy of your story and may use your address information to respond to your story. Thank you.

Please share only my name and story with my state legislators, not my address information.

*First name:


*Street Address:


*State:


*Date:
*Last name:


*City:


*Zip:

*Why is being able to receive services at home important to you or your loved one, and what would happen if you lost them? Please limit stories to 500 words or fewer. Thank you.

For caregivers: If your loved one could not receive in-home care, requiring a greater personal commitment by you, how would it affect your ability to continue working? Please limit stories to 500 words or fewer. Thank you.

*Please check one of the following two boxes:

Yes, I approve sharing my story via the AARP Ohio web page, so that others can read it and learn why Ohio legislators need to adequately fund in-home services. I understand my story may or may not be selected for the AARP Ohio web page.

No, I do not want you to share my story via the AARP Ohio web page. However, I understand my story will still be sent to my state representative and state senator.

*I have read and agree to the terms and conditions below.

TERMS AND CONDITIONS

I understand that one of the purposes of the AARP Ohio In-Home Care Story Project is to collect written personal experiences of Ohioans with the PASSPORT in-home care program, administered through the Ohio Department of Aging. I understand that the product of my participation will be used to publicize the benefits of the PASSPORT program, and to lobby legislators to provide adequate funding for PASSPORT program.

I hereby grant to AARP ownership of my written or oral story that I deliver to AARP and the right to use my name in connection with it in any medium, as well as the right to share my story and name with the media and legislators.

I understand that by signing this release form, I am assigning to AARP any copyright rights that I may hold in this story, and any related materials, and that AARP or its assignees may further assign these rights to others. I warrant that the use of this story and related materials, such as photographs, by AARP and its assignees and licensees will not violate the rights of any other person or entity.

I also grant to AARP and its assignees and licensees my absolute and irrevocable consent for any photographs provided by me or taken of me in the course of my participation in this project to be used, published, and copied by AARP and its assignees and licensees in any medium.

I agree that AARP and its assignees and licensees may use my name, video or photographic image or likeness, statements, performance, voice reproduction, and any other indicia of identity covered by the right of publicity law without further approval on my part.

I release AARP and its assignees and licensees from any and all claims and demands arising out of or in connection with the use of the materials and story provided by me or created in the course of my participation in this project, including, but not limited to any claims for defamation, invasion of privacy, or right of publicity.

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