Thank you for participating in “Your Story Gets Us Closer.” Please fill out the form below completely; and then, if you choose, please feel free to share your story in the bottom field.

NOTICE: By submitting this information to Cancer Horizons you are allowing Cancer Horizons to anonymously add this information to its database and use this information as it sees fit, waiving all rights

If you have opted to submit "Your Story" it will be archived and displayed on the Cancer Horizon site as space allows. Please refrain from using vulgar language or making inflammatory or defaming statements as this will render your submission automatically ineligible for use on Cancer Horizons. Your submission waives all rights and allows Cancer Horizons to use "Your Story” as it sees fit.

If you have opted to submit a picture to accompany"Your Story" you must verify the picture is you, and image cannot be vulgar, By submitting the image to Cancer Horizons, you waive all rights to that image and use tthat image as it sees fit.