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Become a MADD Speaker
If you are interested in sharing your story to the many programs and opportunities MADD CT offers. Please fill out the form below and a Victim Advocate will be in touch with you.
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Name
Your answer
Email Address
Your answer
Phone Number
Your answer
Type of Victimization - You may select more than one
Bereaved
Injured
Property Damage
Type of Crash - You may select more than one
Drunk Driving
Drugged Driving
Poly-substance
Underage Driver
Other:
Year the crash happened
Your answer
Has the criminal court case been sentenced?
Yes
No
Clear selection
What level of presenting are you comfortable with? You may select more than one.
In-Person
Live Virtual
Pre-recorded
Please provide any additional comments here.
Your answer
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