Upload Your Story

2. First Name*
3. Last Name*
5. Zip Code*
6. Age
8. Email*

   Required so that we can contact you with any questions. San Leandro History Museum will not share your contact information.

   If you are also submitting an online writing please be sure to use the same email so we can match your submissions.

10. Please select the file you would like to upload:

12. Files must be less than 25 MB. For larger file sizes email San Leandro Stories.

    Allowed file types: .gif, .jpg, .jpeg, .png, .tif, .txt, .rtf, .pdf, .doc, .docx, .ppt, .pptx, .xls, .xlsx, .mov

14. What type of item are you contributing?

    1. Artwork
    2. Audio
    3. Blog Post
    4. Diary Entry (Print)
    5. Document

    1. Email
    2. Letter (Print)
    3. Photograph
    4. Video
    5. Other
16. Who created this item?*

    This can be an individual, photographer, illustrator, organization, company, etc. Type "unknown" if you are not sure who the creator is.

18. Name(s) associated with item.*

    List people, businesses, and/or organizations appearing in the item.

20. Location*

    Include the address, cross streets, and/or neighborhood that the item is referring to. Be as specific as possible.

22. Measurements (height by width in inches)

    Only needed for printed/analog materials. Example: 5 ¾ x 8 ¼ inches

23. When was the item created?

    If unsure of date, try to provide at least the month and year (MM-YYYY) or just the year (YYYY). Use "Circa" for approximate dates. 

25. Describe this item. What does it tell us about the novel coronavirus pandemic in San Leandro?*

    Include context for this item; description of events related to the item; or relationship between creator and event associated with the item.

27. What else would you like to tell us about this item?
28. Your relationship to the item?*
30. Informed Consent & Copyright Permission Form

    I hereby certify that I am at least eighteen years of age (if under the age of eighteen, form must be completed by parent) and I voluntarily agree to share my interviews, images, and / or personal materials with the San Leandro History Museum, administered by the San Leandro Public Library, to document life during the novel coronavirus pandemic in San Leandro, California.

    1. I agree
32. By submitting my story and its associated elements (the "Story") to the San Leandro History Museum, I acknowledge and agree that the San Leandro History Museum may, in its sole discretion, use the Story as part of a collection of stories (the "Collection"). I hereby grant to the San Leandro History Museum a non-exclusive, worldwide, irrevocable, perpetual, sublicensable, and royalty-free license to use, reproduce, publish, publicly display, excerpt, abridge from, and distribute, in whole or in part, the Story, including my name in association with the Story, in any manner or form, and in any and all media now known or hereafter developed, in connection with or furtherance of the Collection. I waive all common law and statutory rights of publicity and privacy, moral rights, and any other rights that I may have with respect to the Story. I also acknowledge and agree that I shall have no ownership rights in the Collection and that I will receive no compensation for the use of my Story. I also understand that the material I share may not be included in the archive if it is deemed out of scope by Museum staff.

    I represent and warrant that my Story, to the best of my knowledge, does not and will not infringe the rights of any third party.

    1. Yes, I agree
34. I agree that my submission may be shared in whole or in part on Facebook and Instagram and online on the San Leandro History Museum website. Any submissions shared on social media will not contain any personal information. If you wish to contribute a submission, but do not want it shared on Facebook, Instagram or the San Leandro History Museum digital collection click no. You will still be able to submit your story and it will be archived in the Museum.

    1. Yes, my submission may be used on the Museum's social media.
    2. No, do not use my submission on the Museum's social media.
36. Further Information

    For questions, contact the program coordinators via email.

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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field