People Living with HIV/AIDS
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Share your story

We would like to thank you in advance for sharing your story with us. The story you are going to send could be published in our website. Your story will be analyzed and checked for any grammatical mistakes and could be modified to correct the grammatical mistakes. The Nickname field is introduced for privacy purpose. If you don't want us to publish your story with your full name then type a nickname that will be published with your story. If you want the story to have your full name then type again your full name in the Nickname field.

Fields with * sign are required to be filled.

If you would like to send your story in a language other than English, you may do so by printing this form and sending the information by ordinary mail to:

AIDS Resource Center
P.O. Box 26171 Code 1000
Addis Ababa
Ethiopia

Or email to arc@etharc.org

If you would like to publish your story along with your picture then make sure you send your picture to the above mailing address or email to arc@etharc.org with your full name.

We thank you for your contribution in the fight against HIV/AIDS.

 

  Full Name :

   

* Nickname :

   

* Gender :

   

* Age :

   

* Country :

   

  Residence Region :

(only if country is Ethiopia)

   

  Occupation :

   

  Organization :

   

* Association :

(Type "NA" if you are not a member of any PLWHA association.)

   

  Phone Number :

   

  Mailing Address :

  

  E-mail :

   

* Message :

   

*  Story :