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New Chapter Leader Information Form

Welcome to the Changing Spaces Campaign! We are so glad you have decided to become a state chapter leader and make your state a more inclusive place! Please fill out the information below to the best of your ability. Information you provide here will be added to the Changing Spaces Campaign website, so other advocates and organizations in your state will be able to reach out to you.

We rely on social media to network and spread awareness about the Changing Spaces Campaign. Please provide links to any and all social media pages or groups you have formed for your state chapter (Not your personal social media). It is ok if you only have one of these. If you set up more in the future, let us know so we can update the website. 

Please provide a headshot photo of yourself. This will be displayed on our website. A professional headshot is best. If you do not have one, please find a photo of you with good lighting, with only you in the photo, and taken from at least 4 feet away. 

Upload headshot photo

If you would like to provide a few additional photos of your family, yourself advocating, and/or the person who has inspired you to advocate for universal changing tables, upload them below (optional). These will be displayed on your state contact page.

Upload a photo
Upload a photo
Upload a photo
Upload a photo

Thank you for submitting. Please be patient as we add your information to the website.

Please direct any website-related questions

to your website administrators, 

Kim Kirkwood-Boulter

and Jackie Scali, at

Welcome to the campaign!

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