Submit Testimony

This is needed so we can show record that we have done our due diligence to ensure that everything we share on our site and social media is truthful and factual. While we will honor any request to be anonymous when sharing your story, your actual name and the name of the program must be included in this form.

Please check out our Survivor Testimony FAQ for more information about sharing your story.

DECLARATION UNDER PENALTY OF PERJURY

PURSUANT TO 28 USCA 1746

[SPECIAL NOTE: STATUTE DOES NOT REQUIRE NOTARY]

Name of Program *

Name

Dates of Internment (ex. 2005-2007) *

Testimony (Story/Statement) *

I give UnSilenced permission to use this statement on its website and all social media platforms. I declare under penalty of perjury that the foregoing written statement is true and reported from my own first-hand experience.

I agree to the above declaration

First Name *

Last Name *

Failure to provide a name might result in the rejection of the submission.

Do you wish to have your story published anonymously? *

Yes

Email of Declarant *

Phone Number

(Optional) Upload a picture of your time in the program .jpeg, .jpg, and .png file formats only accepted

Choose File

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Submit Testimony

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