diff --git a/src/pages/tell/tell.html b/src/pages/tell/tell.html
index 1fc4390..bda38e3 100644
--- a/src/pages/tell/tell.html
+++ b/src/pages/tell/tell.html
@@ -1,12 +1,33 @@
 <ion-header>
   <ion-toolbar>
-    <ion-buttons right>
+    <ion-buttons left>
       <button ion-button icon-only (tap)="close($event)">
-        <ion-icon name="close"></ion-icon>
+        <ion-icon name="arrow-back"></ion-icon>
       </button>
     </ion-buttons>
+    <ion-title>Submit Your Story</ion-title>
   </ion-toolbar>
 </ion-header>
 
 <ion-content>
+  <p class="intro">Submit your story using the following form. Nicholas may be in touch to clarify what you’ve written and he reserves the right to vet stories for accuracy and appropriateness.</p>
+  <form [formGroup]="userSubmissionForm" novalidate>
+    <ion-item>
+      <ion-label>Upload a photo</ion-label>
+      <input type="file" formControlName="pic" name="pic" />
+    </ion-item>
+    <ion-item>
+      <ion-label>Display name</ion-label>
+      <ion-input type="text" formControlName="name" name="name"></ion-input>
+    </ion-item>
+    <ion-item>
+      <ion-label>About you</ion-label>
+      <ion-textarea formControlName="about" name="about"></ion-textarea>
+    </ion-item>
+    <ion-item>
+      <ion-label>Your schtick with #gays</ion-label>
+      <ion-textarea formControlName="messages" name="messages"></ion-textarea>
+    </ion-item>
+    <button ion-button type="submit" block [disabled]="!userSubmissionForm.valid"  (click)="saveUserSubmission()">Submit</button>
+  </form>
 </ion-content>
diff --git a/src/pages/tell/tell.ts b/src/pages/tell/tell.ts
index 39fe021..a5fcd60 100644
--- a/src/pages/tell/tell.ts
+++ b/src/pages/tell/tell.ts
@@ -1,5 +1,6 @@
 import { Component } from '@angular/core';
 import { NavController } from 'ionic-angular';
+import { FormBuilder, FormGroup, Validators, FormControl } from '@angular/forms';
 
 import { ProfileService } from '../../services/profiles';
 
@@ -11,9 +12,17 @@ import { ProfileService } from '../../services/profiles';
 export class TellYourStoryPage {
 
   tabNavEl: any;
+  userSubmissionForm: FormGroup;
 
-  constructor(public navCtrl: NavController) {
+  constructor(public navCtrl: NavController, private formBuilder: FormBuilder, private formControl: FormControl) {
     this.tabNavEl = document.querySelector('#tab-nav .tabbar');
+
+    this.userSubmissionForm = this.formBuilder.group({
+      name: [''],
+      about: [''],
+      pic: [''],
+      messages: ['']
+    });
   }
 
   ionViewWillEnter() {
@@ -23,4 +32,8 @@ export class TellYourStoryPage {
   close(event) {
     this.navCtrl.pop();
   }
+
+  saveUserSubmission() {
+
+  }
 }