Missing Mama:

The Experience of Mother Absence in African American Communities

Survey 1: Mother Absence Due to Death

There is much written and discussed about the absence of African American males as fathers in the African American communities. The intent of this survey is to capture the experience of mother absence in the African American communities from the men, women and children who are “Missing Mama” through the circumstances of death.

About you:

First Name:

Gender:

Male
Female

Age:

Education Level:

Profession:

Annual Income:

Religion:

City: State:

Where do your people come from?

Do you have children?

What are their ages?

If you have more than one child, please seperate the ages by a semi-colon (;)

About Your Experience:

How old were you when your mother died?

How old was she when your mother died?

How did she die?

Who lived with you at the time of her death?

Please list all persons.

How were you told about her death?

Who (or what) assisted you (and in what ways) with your sadness (grief and sorrow)?

Who took over the mothering role?

Did your father remarry?

How soon after your mother's death?

Have you completed your grief process regarding the loss your mother's death created?

Are you still in the healing process?

In your own words, please tell how significant the death of your Mama has been for you throughout your life, including possible influences on your development, your personal or intimate relationships, and parenting your own children.

Do you have any additional comments?

Are you willing to complete a recorded phone interview?

If so, please submit your phone number, so that I can contact you.

If my story is chosen for inclusion in the book, I would like it to be identified in the following manner:

First Name
Age
Profession

THANK YOU for completing this survey. Your story and experience about Missing Mama may be included in the “MISSING MAMA" trilogy.

This is a work in progress by Early Education and Child Development Consultant, Amoke Kubat. By completing this survey, you understand and agree that you will receive no compensation for the written appearance of any part of your story that you have submitted. All survey information will become exclusive property of the author, as they have been written. I understand that my participation in this survey has been completely voluntary, and I had the right to discontinue my entry at any time. By checking the box below, and completing the above form, I am therefore providing consent to participate in this survey.

I agree.

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Wanted:

African American Men, Women and Children who have experienced mother absence....

What happens when African American mothers are absent? Your stories and experiences are needed.

Please take the time to fill out a survey specific to your experience: Loss Due to Death or Loss Due to Other Circumstances.

You can read more about this trilogy on our main Missing Mama page, or an excerpt from the first book in the series: Missing Mama: The Experience of Mother Absence.

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