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Break The Silence DocuVlog

Thank you for your interest in our annual "Break The Silence" Series. This is one of K-Pop For Peace's signature projects.  *PLEASE NOTE THAT THIS IS A SIGNATURE PROGRAM CREATED BY THE FOUNDER OF K4P AND IS NOT TO BE DUPLICATED BY OUTSIDE PARTIES. THIS PROJECT IS ALSO NOT AFFILIATED OR SPONSORED BY ANY K-POP GROUP/COMPANY*

This series is dedicated to K- Pop fans who are facing mental health crises in their daily lives. The first year we did this project, K-Pop Fans were able to discuss how K-Pop has positively influenced their mental health. This year we will be continuing this concept, but with additional content.

For this project, you will be able to discuss anything you wish to address within your comfort zone.

You have the option of blurring your face for the video series and can be provided an alias. There is more documentation needed to ensure there are no violations  during this project for the protection of participants and K-Pop For Peace.

By filling out this form, you are NOT being held to participate in the project. This form is to gather the list of participants so that K-Pop For Peace can schedule a time to have a conversation with you to ensure this is something you want to do.

Thank you for taking the next step towards having your voice heard and being the voice for those who have been silenced due to the oppression they are facing in our society/world.

What is your first and last name?

What is your age?

How do you identify?

How do you identify?
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D

How would you like me to refer to you?

How would you like me to refer to you?
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B
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When is your birthday?

What is your email address?

What is your address? This will be for a surprise gift sent for participation in the DocuVlog.

Let's Dive A Little Deeper

What are some things you wish to say to viewers in regards to your journey and/or advice you wish to give others who are on their own journey towards a better mental health space?98y

List your top 3 concerns you have about your mental health.

Why did you choose those 3?

What are you willing to work on to reach your goals?

What aren't your willing to do to reach your goals?

What are the top 3 things you're interested in changing?

Please list all of the obstacles you feel like you're facing when it comes to achieving your goals? This can be with your mental health goals or any other goals that you may have.

On a scale of 1-10, how would you rank your mental health right now? There is no wrong answer, we just want honesty so that we can help you for the duration of this project and beyond if you wish to continue participating in K4P activities. g

On a scale of 1-10, how would you rank your mental health right now? There is no wrong answer, we just want honesty so that we can help you for the duration of this project and beyond if you wish to continue participating in K4P activities. g

Disclaimer

By filling out this form, you are expressing interest in learning more about the project and how to become a participant. You are NOT held to any contract by completing this form. However, you understand that once you have been invited and accepted as a participant, you will have to follow the guidelines to promote safety of yourself, other participants and the nonprofits involved. You also understand that contracts are needed to ensure a smooth process during this project. Contracts will be delivered through email and will come with a due date to continue your participation.
By clicking the yes button below, you're agreeing to the disclaimer and that all of the information you've provided above is accurate and up to date to the best of your knowledge.
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By completing this form, you understand that Break The Silence is NOT associated with a K-Pop group/company. You also understand that Break The Silence and it's signature components are the trademark for K-Pop For Peace and isn't to be duplicated.

By completing this form, you understand that Break The Silence is NOT associated with a K-Pop group/company. You also understand that Break The Silence and it's signature components are the trademark for K-Pop For Peace and isn't to be duplicated.