Survey & Form Center

2. 
4. Success Stories

   Our goal is to share with the general public stories reflecting how their COMBAT tax dollars are being used to improve individual lives and the quality of life in our community. This form is to be completed by organizations receiving COMBAT funding to submit their success stories. Each agency is required to submit two stories per year.

   COMPLETE STORIES REQUIRED
   Submitted stories should be fully-developed articles, meaning that little, if any, follow-up work should be required by COMBAT staff. This means being away that the intended audience for theses stories are the general public.

   While we want to publish as many success stories as possible, all may not be posted on jacksoncountycombat.com.

   PSEUDONYMS
   You may use pseudonyms for any client(s) mentioned in your success story. If you do so, it should be clearly stated in the story that a psuedonym is being used. You many also use the first-name only of client(s) mentioned in the story.

   ARTWORK
   While you may have clients who don't want their real names being used in a success story, it is important that you provide some artwork to include with each story submission: logos, photos from events/programs, etc.

   CONSENT FORMS
   Acquire consent forms from any individuals mentioned in the artilce or shown in photographs.

   IMPORTANT
   To submit this form you do not have to sign in or create a Form Center account (above). However, you will have to complete the form in its entirety, without the option to save your progress unless you do create an account.
   
   CREATING A FORM CENTER ACCOUNT
   » Former Center Account Set-up Instructions

6. — Organization's Name*
8. — Contact

   Person submitting this success story

10. Name*
11. Title*
13. Phone Number*
14. email*
16. — Success Story
18. Constent Form(s)*

    Do you have constent form(s) from individuals mentioned in the article or shown any photo graphs you've be submitting?

    1. Yes
    2. No
20. Article*

    300-800 Words. Include captions for submitted photos (.PDF and Word Documents Accepted)

22. Photo/Artwork*

    .jpeg and .png

23. Photo/Artwork

    .jpeg and .png

25. Photo/Artwork

    .jpeg and .png

26. Photo/Artwork
28. — Questions

    Questions can be directed to COMBAT Communications Administrator Joe Loudon at 816-881-4337 or jloudn@jacksongov.org.

30. — Signature

32. By typing your name in the "Signature" box below, you acknowledge that this "electronic signature" is valid to the same effect of a traditional handwritten signature.

34. Signature*
35. Date*
    Date
37. Title

    If not listed above

38. e-mail

    If not listed above

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field