AARBF 50th Anniversary: 50 Stories Coffee Table Book
In celebration of AARBF's 50th Anniversary, we are working on putting together a commemorative coffee table book that will include 50 stories....YOUR stories! These will be stories from burn survivors, volunteers, firefighters, nurses, educators, donors, family members, friends...everyone who has made AARBF what it is today!

Please be sure to provide as much detail as possible in your responses. We will try our best to capture the essence of you in this book!

If your story is selected for our 50th Anniversary Coffee Table Book, you will be asked to participate in a professional photo shoot scheduled for March/April 2021. More details to come.

DEADLINE TO SUBMIT YOUR STORY: January 31, 2021

Feel free to contact Jennifer Radics-Johnson, Executive Director, at jradics@aarbf.org or (818)848-0223 ext. 12 with any questions or concerns.

Please note: Space is limited in the book, and unfortunately not all stories will be featured. Your story may be used for AARBF's website, social media pages, newsletters and other public and promotional documents and media.
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1. First and Last Name *
2. Camp Name (If Applicable)
3. Date of Birth *
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4. Email Address *
5. Phone Number *
6. I am: (Check all that apply) *
Required
7. When and how were you burn injured? (If you are not burn-injured skip to Question #9)
8. How did your burn injury affect your life? (If you are not burn-injured skip to Question #9)
9. When did you first become involved with the Alisa Ann Ruch Burn Foundation? *
10. What events/activities were you involved in with the Alisa Ann Ruch Burn Foundation? *
11. What is your favorite AARBF memory? *
12. How did AARBF impact your life? *
13. What are you up to now? *
14. I authorize the Alisa Ann Ruch Burn Foundation to use my story, written submission, photographs and/or video of me for use for its 50th Anniversary Coffee Table Book, website, social media pages, newsletters and other public and promotional documents and media. *
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