Have you or a family member recently returned from serving in Iraq?

KQED wants to talk to military families who have had a member of their family recently return from Iraq.

* indicates required field

First Name *

Last Name

E-mail *

Phone *

Postal Code

In what area of the armed forces do you or did you serve?

Where were you deployed and for how long? Do you expect to be deployed again?

When did you return or when are you scheduled to return to the U.S?

Describe your experience coming home -- what have been the high points and low points? What, if anything, has surprised you?

Is there anything about your service or your return home that you would like us to know?

And now a few questions to help us get to know you better. This information, like all of your answers, will not be shared outside of PIN newsrooms.

In what year were you born?

What race or ethnicity are you?

What political party, if any, do you identify with most closely?

Your Information

By completing this form, you become part of American Public Media's Public Insight Network (PIN). KQED, American Public Media and any other PIN newsroom listed on this form may contact you for help with current and future news coverage.

This submission may be shared with journalists at KQED, American Public Media and other news organizations collaborating on reporting. It will not be used for marketing or fundraising purposes, and we will never quote you without first getting your explicit permission.

If you give us permission to publish your submission, we may edit before sharing it on-air, in print or online. We reserve the right to reuse or republish your submission, or to withhold your submission from publication. You must be 13 years or older to provide a submission.

About the Public Insight Network

Founded in 2003, American Public Media's Public Insight Network is a platform for connecting trusted journalists with knowledgeable sources and for fostering journalistic excellence, innovation and collaboration. Learn more »

Through American Public Media, you may have opportunities to also inform reporting for Marketplace, Marketplace Money, On Being, American RadioWorks and other partner newsrooms.