pedophile-unmasked-form,page

Wednesday 14 February 2007

Please Take Note

I am not the Authorities so reporting to me doesn't mean help is on its way. Unless you specifically ask me to do something, everything you say is confidential and will not be repeated or acted upon. If you want help but just don't know how, well then I can show you ways to be free and safe.

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Posting Permission Form

Name you want to be called:
Email Address if you want a response (OPTIONAL):
Are you male or female?:
How old were you when this happened to you?:
How old are you now?:
Are you still being abused?:
Was the Perpetrator a relative?
Did you ever tell anyone?:
Do you feel that if you disclose this act against you that your family will be destroyed and blame you?:
What would you like me to know?:
Do you want me to reply to you about this?:
If Yes, How would like me to help?:

simple html form

pedophile-unmasked-form,page

Wednesday 14 February 2007

Please Take Note

To go back to oringinal page

Posting Permission Form