Personal History Questionnaire

Please briefly answer each question that applies to you and your life. Feel free to jump around and skip sections that don’t apply to you.

This form is set up so you may come back to it as often as you need prior to submitting your answers.

Use the “Save and Continue Later” feature at the bottom to do that. 

Providing this information helps me create the outline for our filmed interview session(s). Take your time with this and enjoy reflecting back on your life and all the experiences you have had!

Printable Questionnaire

Below is the e-version of the questionnarie. If you prefer to hand write your answers, please download the printable version and mail back to me.