Documenting the Experiences of Our Community During the Novel Coronavirus (COVID-19) Pandemic

Full Name 


Email  


Age (optional)


Phone Number (optional)


Tell us your coronavirus story (how has the pandemic impacted you and your family, work, social life, etc.)

Some ideas to share:
Where and who are you staying with?
How are you getting your basic necessities (food, medicine, household supplies, etc.)?
What is your employment situation?
What do you miss the most during this time?
What do you most look forward to once the stay at home order is lifted?
What will you remember most about this time?
Can you tell us of a local hero?


Do you have any photos, videos, or objects to go with your story? If yes, please describe below. 

Would you be willing to participate in an oral history interview about your experience during COVID-19? 
Yes    No 

 By submitting this form I give permission to the Niles History Center (NHC) and the City of Niles to use the submitted work for all standard Museum and public relations purposes including but not limited to exhibition, loans, reproduction, education programming, online publication and transmission. I give permission to NHC to add the submitted work to the Museum’s Collections in accordance with the Niles History Center's Collections Policy. The NHC reserves the right to remove content that it considers duplicative, inappropriate or outside the scope of this project. The NHC is not obligated to include your content in this project or preserve it in perpetuity. I am at least eighteen years of age. If under the age of eighteen, material must be submitted with consent of parent/guardian. We will not share your email or phone number.