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Please tell me a story about a time when conflict or violence made a difference to your life:
   
 
 
 
Please give your story a title:
   
 
 
 
What role did you play in this story? You were:
 
A victim
 
A participant
 
A witness
 
 
 
How did this change your life?
 
Made it better
 
Made it worse
 
 
 
This story makes you feel:
 
Happy
 
Neither happy nor sad
 
Sad
 
 
 
When did/does this story take place?
 
It is still happening
 
Less than a year ago
 
More than a year ago
 
 
 
What would you like to change the most as a result of this incident:
   
 
 
 
How old are you?
   
 
 
 
Are you:
 
A woman
 
A man
 
 
 
What is your level of education?
 
Unemployed
 
Primary school
 
Metric
 
Intermediate or vocational training
 
Graduate or above