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Zine Response Form
Any feedback on our zine would be greatly appreciated!

 You can also enter our giveaway for a pair of Museum of Science Boston tickets by completing this form! Some things to note:  
- Winner is selected at random.
- Entering the giveaway does not guarantee that you’ll win the giveaway.
- If you’re selected, the email you submit for the giveaway is the email we will reach out to get your mailing address for the tickets, so please be mindful of spelling!
- This form and giveaway is open until Wed June 8th.

This form will close on Thurs June 9th.
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Are you interested in being entered into a giveaway to win ONE pair of Museum of Science Boston tickets? If yes, please enter your email below. If no, please skip this question.  
How are you connected to this work? *
Required
What is your age? *
What racial category would you put yourself in? *
If selected Multiracial, please explain.
If racial identity is not listed, please explain:
What ethnic category would you put yourself in? *
If ethnic category not listed above, please explain:
What is your current gender identity? *
If current gender identity not listed, please explain:
What words do you use to describe your sexual orientation? *
Required
If you describe your sexual orientation with other words, please explain:
What is your current stance on the Healthy Youth Act? Please elaborate in the space below. *
Strongly Against
Strongly Support
Please use this space to elaborate on what informs your current stance on the Healthy Youth Act. *
Where did you learn about this zine project? *
Did you have any knowledge of the Healthy Youth Act before seeing this zine? Please explain. *
What would you need to effectively implement (or support the implementation of) comprehensive sexual health education curriculum? *
What else would you like to know about the Healthy Youth Act? What else would you like to know about the topics covered in this zine? *
Are you interested in participating in the HYA Coalition? *
If you answered "Yes", please leave your email below and we'll send you an email on how to get involved. If you're unsure, please visit https://www.healthyyouthact.org/ .
Do you have any further questions or comments?
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