Name *

Your name and contact information will be used by NAAFA and/or FLARE (Fat Legal Advocacy, Rights and Education Project, a project of the law offices of Brandy Solovay) to reach you regarding your experience. Your contact information will remain confidential. Neither your name nor your story will be made public unless you permit us to disclose it to people outside of our teams (see checkboxes below).

First Name

Last Name

Phone

(###)

###

####

Address

Providing your address allows us to contact you regarding legislation that is specific to your area, as well as to inform legislators how many of their constituents have signed this petition. You will not receive mail from the Campaign for Size Freedom or its partners, and your address information will not be used in any other ways.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which category best describes the discrimination you experienced? *

Education

Employment

Housing

Public Accommodation

Other

When did you experience this discrimination? *

I experienced this in the past.

I am experiencing this now.

How may we use your story? *

I agree to be contacted by NAAFA and/or FLARE regarding my experience.

I am willing to testify in person about my experience

I am willing to testify virtually about my experience.

I am willing to speak to the media about my experience.

I am willing to have my story and basic demographic information shared publicly, but I wish to remain anonymous.