Guest Speaker Form for Mothers Against Addiction

We appreciate your time and willingness to participate in a Mothers Against Addiction article and be a guest speaker with us. This form is designed to help us learn more about you and your unique experiences.

Please keep in mind that your responses will serve as the foundation for the profile we will be crafting, and they may be edited for clarity and style. Our goal is to create a captivating and comprehensive portrayal of you.

Here are some tips to guide you:

This is only a rough outline of you. We will dive deeper into you and your story during the live guest speaker meeting.
Relax and enjoy the process. Your answers will be used to shape the article, but they won’t be directly quoted.
Don’t worry about grammar, punctuation, or spelling. We will handle the proofreading and editing.
Provide detailed answers. Longer responses give us more material to work with.
Aim for approximately one paragraph (4 sentences) per answer, but feel free to provide additional information if desired.

We are excited to hear your story and share it with our readers. Thank you for helping us all in the struggle against addiction.

The Mothers Against Addiction Team

Name:

Email:

Instagram and/or Facebook URL

Other Social URLs

Youtube Video Showcasing You (If Any)

Website (If Any)

Can you start by telling us a little about yourself? (Background, profession, personal journey)

Could you share how addiction has personally impacted your life or the life of someone close to you? (How did it affect your family, relationships, and daily life?)

What advice would you give to mothers who are struggling with their own addiction or are supporting a loved one through theirs? (Any practical tips or words of encouragement?)

What were some of the biggest challenges you faced during your journey with addiction, either personally or as a supporter? (How did you overcome these challenges?)

How did you find the strength and resources to keep going during the toughest moments? (What role did support systems, therapy, or other resources play?)

What message would you like to share with mothers who feel isolated or hopeless in their battle against addiction? (What can they do to start the healing process?)

Are there any specific resources, programs, or strategies that you found particularly helpful in dealing with addiction? (What would you recommend to others in similar situations?)

Open Discussion: Is there anything else you would like to share about your experience with addiction or your journey through recovery that we haven't covered in the previous questions? This could be a story of resilience, a powerful lesson learned, or a memorable moment that profoundly impacted your understanding of addiction.

Photo Upload: Please upload up to 4 photos that will be used in the article. *You must own or have copyright permission.*

Photo Release Statement: I hereby grant Mothers Against Addiction and its agents the absolute right and permission to use, reproduce, publish, and distribute the photographs I am uploading for the purposes of its website, and any promotional materials related thereto. I hereby represent and warrant that I am the lawful owner of these photographs, and I have the legal rights necessary to grant the permissions herein. I agree that this grant of rights is irrevocable, worldwide, and perpetual, and it includes Mothers Against Addiction the right to use the photographs in whole or in part, without payment or other consideration to me. By uploading these photos, I acknowledge that I have read and agree to these terms.

I acknowledge and agree that Mothers Against Addiction and its agents have the right to create, reproduce, publish, and distribute an article about me and my responses to this interview. I understand that this article may be used in its website, and any promotional materials related thereto. I hereby grant Mothers Against Addiction and its agents the rights to use my name, biographical information, interview responses, and any photographs I have provided, in connection with this article. I understand that this grant of rights is irrevocable, worldwide, and perpetual. I confirm that my responses to the interview are truthful and accurate to the best of my knowledge, and I understand that Mothers Against Addiction is relying on this affirmation in publishing the article. I acknowledge that I have read and agree to these terms.

Guest Speaker Form for Mothers Against Addiction

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