Interview Interest
Thank you for your willingness to share more of your experience through an interview. Complete this form and we will reach out to schedule a time.
Privacy notice: Draft responses may be stored in this browser for up to 7 days to prevent data loss. Do not use draft saving on a shared or public device. Use "Clear saved draft" before leaving if this is not your personal device.
Have you participated before?
If you have participated before, you can link this submission to your existing record.
Contact Information
US numbers autoformat; international numbers may begin with +.
Preferred contact method
If you have a LinkedIn profile and are comfortable sharing it, you may include it here to help us better understand your professional background.
Interview Format
Relevant Sectors
Select the sector or sectors your story connects to. This may be a field you worked in, led in, served in, or a system you interacted with as a patient, client, student, family member, community member, or advocate.
Business, technology, finance, entrepreneurship, corporate leadership, and economic advancement.
Healthcare workplaces, patient care, public health, caregiving, advocacy, and healthcare systems.
Military service, veteran transition, military family life, and service-connected professional experiences.
K-12, higher education, student experiences, faculty/staff roles, and education systems.
Government agencies, public administration, civic leadership, policy, and public-sector service.
Police, fire, EMS, corrections, emergency response, FBI, or law enforcement-related service.
Foster care, child welfare, family services, caregiving systems, and related advocacy.
Courts, attorneys, judges, legal aid, prosecution, defense, probation, and justice system navigation.
Another field, institution, or system connected to your story.
Topics & Background
Preferred Availability (optional)
Select any days and time windows that generally work for you. We will confirm specific scheduling before your interview.
Days of the week
Preferred time windows (Pacific Time)
Consent
Participation Level
Attribution Preference
Options shown here are limited by the participation level selected above.
Selected consent summary
Your name and story may be published in full with your permission.
Consent Agreement
The BlackPrint Project is a legacy initiative created to capture, preserve, andelevate the lived professional experiences of Black professionals acrossAmerican institutions.
Your story matters. Your experience has value. This project exists because whatyou have navigated, contributed, endured, built, and transformed insideprofessional and institutional systems deserves to be documented, studied, andremembered.
The BlackPrint Project may use submitted experiences for story collection,pattern analysis, educational content, publications, media, podcasts,documentary content, and institutional learning resources. Your participationlevel determines exactly how your contribution is used.
Before you begin, please read the participation levels below and select the onethat feels right for you.
What this means:Your name, professional background, and story may be published, quoted, cited,or featured in BlackPrint Project materials including publications, articles,podcast episodes, documentary content, presentations, social media, andeducational resources.
What we will do:• Use your name and professional context as you provide them• Share your story in published materials with your identity attached• Credit you as a contributor unless you request otherwise
What we will not do:• Share your contact information publicly• Publish anything beyond what you submit without your additional consent
Your rights:• You may change your participation level or withdraw your consent at any time for future use of your contribution by contacting The BlackPrint Project team• Previously published, printed, distributed, archived, or publicly released materials may not be removable• You may request to review how your story is used before publication for high-sensitivity stories or upon request, subject to operational feasibility
The BlackPrint Project may involve stories that touch on workplace dynamics,systemic barriers, discrimination, retaliation, health, trauma, legal matters,and other sensitive professional experiences.
Please do not submit:• Confidential employer information or trade secrets• Private personal information about identifiable third parties without their consent• Legally restricted or classified material• Information subject to active litigation where disclosure could affect legal proceedings
If your story involves sensitive content, you may select a higher level ofanonymity (Level 3 or Level 4) or request to discuss your submission with theproject team before finalizing.
The BlackPrint Project reserves the right to edit submitted content for clarity,length, grammar, formatting, and thematic grouping while preserving the meaningand integrity of your contribution. No edits will alter the intent of your story.
How your information is handled:Your responses are stored securely and accessible only to The BlackPrint Projectcore team. Your contact information is kept separate from published content.Your data will not be sold, shared with third parties for marketing purposes, orused for any purpose beyond The BlackPrint Project's stated mission. You mayrequest access to, correction of, or deletion of your personal data at any time.