Success Story Submission Form

Just like you, I went through a lot of hardships in life. Through my Facebook page and this website, I’ve been sharing bits and pieces of my life from my struggles to my successes. I’ve learned that people get inspired when I let them know that I also went through what they are going through. When I begin my story with the hardships I went through and end it with how I triumphed over those challenges, I know, in one way or another, I am putting fire in your belly and springs under your feet to say with conviction, “I can succeed, too! I know I will through Christ who strengthens me!”

I don’t want to (and I can’t) monopolize the stage when it comes to inspiring and motivating people to get into action. I want to share the stage with you. I want to re-focus the spotlight on you.

See, who would have thought that you are where you are now 5 or 10 years ago?
Who would have thought that who was once a borrower is now a lender?
Who would have thought that who was once bullied is now running a campaign on anti-bullying?
Who would have thought that who was once asking for donations is now a philanthropist who has foundations?
Who would have thought that who was once receiving rejections left and right is now a sought-after priest, nun, doctor, engineer, architect, lawyer, teacher, dentist, analyst, programmer or entrepreneur?

These “who would have thought” moments were all once question marks that are now straightened out exclamation points of your life! Didn’t you realize that?

My friend, you can help me in this project of broadcasting to the world the magnificence of the Filipino people! You have a gift that only you can give to this world! You have a unique success story that no one else can tell to this world.

I’d like to personally invite you to send your success story to me whether it’s about your family, business, finance, school, or whatever. Perhaps, you’d like to ask if this isn’t an additional operational expense to me and if this doesn’t eat a portion of my time. Yes, it is and it does, but I’ve decided to give birth to this brainchild because I know you want to tell your story but you don’t know how to express yourself or how to put your thoughts into words. I know you want to tell your story but you’re half-hearted to do that because you doubt yourself on whether someone will read your story or listen to you. I’d like to tell you that I want to read and listen to your story.

With that, me and my team have created an outline that you just need to fill-out. Write in English, Taglish, or Tagalog. Don’t worry about grammar; we can take care of that. Me and my team will help you put your story in writing. Then, I will publish it on my website and post it on my social media accounts so that thousands of people who visit my website and social media accounts would be inspired by your story. If we have follow-up questions, we’ll contact you. We’ll send you a copy of the story before we publish it on the site.

Alright! The world awaits you. Fill-out the form now!

Terms & Conditions

I am going to submit my story to Mr. Jaycee S. de Guzman through the story-sharing feature of www.jayceedeguzman.com. I realize that this story I am submitting can be widely used by Mr. Jaycee S. de Guzman. My success story is submitted in compliance with the following conditions:

1. I warrant and represent that I am my success story’s only author; that my submission is not misleading and is true; that I own all the title, right and interest to and in the story I am submitting; that I own all unconditional and exclusive authority and rights to submit, as well as convey my success story to Mr. Jaycee S. de Guzman upon all the terms and conditions this website has set; and that there are no third parties that can be entitled to any kind of payment or consideration as some form of condition in my story’s exploitation.

2. I hereby give Mr. Jaycee S. de Guzman a worldwide, perpetual, transferable, royalty-free license, along with sublicensing rights, to have my story published, be used for publicity or advertising purposes and use my story (or any derivation or portion thereof) in print, audio, video, web, and forms of media (which include, having no limitation, all and any social media) and in all kinds of radio, internet, live stage or television program. I also agree that I won’t be entitled to receive any payment or compensation due to the use of my submission. I understand that Mr. Jaycee S. de Guzman may publish, create and otherwise make use of dramatized or fictionalized versions of my success story and I give Mr. Jaycee S. de Guzman the right to adapt, fictionalize and dramatize my success story for such purpose. Furthermore, I agree and acknowledge that others can give comments or feedback to the story I submitted and neither Mr. Jaycee S. de Guzman’s affiliates nor Mr. Jaycee S. de Guzman’s website itself shall be held liable or responsible for the comments and feedback. Also, Mr. Jaycee S. de Guzman cannot have the full guarantee that others are not going to use my success story and that Mr. Jaycee S. de Guzman and its affiliates aren’t liable and responsible for any misuse, use or misappropriation of my success story by other people.

3. I understand that Mr. Jaycee S. de Guzman would choose to refuse to take my success story without my acceptance of every provision of this license and release. I also acknowledge that no confidential or fiduciary relationship now exists between me and Mr. Jaycee S. de Guzman and that no kind of relationship is established between me and Mr. Jaycee S. de Guzman due to this license or release or due to the submission of my success story.

4. I agree to give Mr. Jaycee S. de Guzman the indemnification against and from all and any claim, liability, loss or expense that can be asserted against Mr. Jaycee S. de Guzman or caused by Mr. Jaycee S. de Guzman at any given time in relation to my success story, or all types of use thereof, which includes without limitation the ones brought about by any warranty breach and promises that I give herein.

5. I hereby agree and I acknowledge that there exists no contemporaneous or prior oral or any kind of agreement in effect that between me and Mr. Jaycee S. de Guzman which pertains to my success story or to any kind of material, not considering that these terms of use which can be applied to www.jayceedeguzman.com may also be applied to my success story submission and other related materials, to the point not contradictory with this license and release.

6. The Philippine Constitution shall govern this license and release applicable to all agreements implemented and to be wholly performed therein.

7. The submission of my story indicates that I have fully read and understood the provisions and conditions in this license and release and no form of oral representation has been given to me. This license and release mentions our whole understanding in accordance to the subject matter thereof.

Full Name

Email

Address

Mobile #

Place of Birth

Educational Attainment

Let's talk about your success story.
Feel free to write in English, Taglish, or pure Tagalog.

What's the central theme of your story?
ArtBusinessEducationEnvironmentFaithFamilyFinancesFriendsFutureGoalsGratitudeHealthJobMusicPetsRelationships

How did everything begin?

What challenges did you face?

What have you learned from every challenge that you faced?

What solutions to these challenges did you come up with?

Were there people who helped you in the process? Who are they and how were they able to help you?

What makes your story unique?

What advice will you give to people who are going through or who went through the same experience that you had?

What saying/quotation has inspired and motivated you throughout your journey to success?

How do you define success? What is the meaning of success for you?

Upload your picture(s) here. Put them together in MS Word or MS PowerPoint so you can send them at once.One to five pictures will do. Please limit your file's size to 10MB.