Project Rollway 2024 Model Questionnaire

Asterisk (*) indicates required.

First Name

Last Name

Email

What size t-shirt would you like?

What size pants to do you wear?

Please specify if the size above is men's or women's sizing.

How old are you?

What city are you from?

What state are you from?

When were you injured?

How were you injured?

What do you enjoy doing in your free time?

What is your dream for yourself in the future?

What is your dream for Shepherd/the community/the world in the future?

What is your favorite Shepherd memory?

What are 1-3 fun facts about you?

Please upload a photo for your model bio.

Please provide 3-5 additional photos of yourself that you'd like to include in the model slideshow. These images can highlight your hobbies, moments with family or friends, participating in therapy, etc.

Photo #1

Photo #2

Photo #3

Photo #4

Photo #5

Contact Information