Share Your Story With Us
Thank you for offering to share your experience with us. Your participation reflects our true mission to raise awareness for the disease and to continue to spread hope.

Please fill out the questions (or make it your own) and attach a photo. You can also share your blogs, links, or any other social media accounts.
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Email *
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Your Name: *
Your Family Member Name :
Are you: *
Age at diagnosis: *
City, State, Country
Is this an "In Memory" Post?
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How were you diagnosed?
What was your treatment?  
What is your hope? Or what do you want to share with others?
Media Release: I grant to Hope for Stomach Cancer a 501 (c)(3) nonprofit, its representatives the right to distribute my story or any information that I choose to share- including a photograph. I authorize Hope for Stomach Cancer a 501 (c)(3) nonprofit, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that  Hope for Stomach Cancer a 501 (c)(3) nonprofit may use such my story and/or photograph with or without my name and for any lawful purpose. *
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Non-Disclosure: Volunteer shall keep in confidence any Confidential Information obtained as a member of the young adult committee, or related to being in the young adult committee, and shall not use it or divulge it to any person without the written consent of STOCAN. “Confidential Information” means any and all information disclosed to the young adult committee or known by volunteer as a consequence of the volunteers’ relationship with STOCAN, and not generally or publicly known about STOCAN, including but not limited to: financial information, donor information, fundraising strategies, and confidential programming information.   *
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This signup form functions as an online electronic signature. *
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Thank you! Please email a photo or two to Hope@stocan.org with your name in the subject line.
A copy of your responses will be emailed to the address you provided.
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