SNAPIQS Membership Form
Thank you for your interest in joining the SNAPIQS, aka Southern Nevada Asian Pacific Islander Queer Society!
The Southern Nevada Asian Pacific Islander Queer Society (SNAPIQS) serves all Asian, Pacific Islander, and Desi American of all sexual orientations, gender identities, and gender expressions (SOGI/E or LGBT*) in the Southern Nevada region. Through social and cultural activities, education, mentorship, awareness, and advocacy, we aim to create an inclusive, affirming, and empowering community.
Joining the organization is FREE!
For more info, visit
www.snapiqs.org
!
* Required
First Name
*
Your answer
Last Name
*
Your answer
Preferred Pronouns
*
(he/him/his; she/her/hers; they/them/theirs/; etc)
Your answer
Email Address
*
Your answer
Phone #
*
Format Example: (7024445555)
Your answer
Birthday
*
MM
/
DD
/
YYYY
What gender do you identify as?
*
Cisgender refers to your sex assigned at birth and gender aligning.
Cisgender Male
Cisgender Female
Transgender Male
Transgender Female
Intersex
Prefer not to disclose
What sexual orientation do you best identify with?
*
Asexual
Bisexual
Gay
Lesbian
Pansexual
Queer
Straight
Ally
Prefer not to disclose
Other:
Required
Which of the following best describes your race?
*
African American
Asian/Pacific Islander
White
Hispanic/Latino
Native American
Prefer not to answer
Other:
Required
What best describes your ethnicity?
*
Ethnicity is how you identify based on nationality, language, culture and religion. It can also be based on your geography or your family's origin. Examples include: Algerian, Burmese, Chinese, Filipino, Ghanaian, Indian, Lao, Japanese, Thai, Vietnamese, etc.
Your answer
Where in Southern Nevada do you reside?
*
Boulder
Downtown/Las Vegas
East
Henderson
Mountain's Edge/South
North Las Vegas/Aliante
Spring Valley
Summerlin
Non-Las Vegas
Other:
Why are you interested in being part of the SNAPIQS community?
*
Your answer
Please rate your interest in the following events from 1 (least favorite) to 4 (most favorite).
*
1
2
3
4
Social Events
Cultural Events
Advocacy/Political Events
Education/Workshops
Organization Planning
Community Outreach
1
2
3
4
Social Events
Cultural Events
Advocacy/Political Events
Education/Workshops
Organization Planning
Community Outreach
Please select the top three days and times where you would be most available for SNAPIQS activities.
Activities include events and general meetings.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning (8am- 12pm)
Afternoon (12 pm - 5pm)
Evening (5pm - 9pm)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning (8am- 12pm)
Afternoon (12 pm - 5pm)
Evening (5pm - 9pm)
How did you hear about us?
*
Social Media
Friend
The Center
Partnered Organization
Previous Event
Other:
Required
Questions, comments, concerns?
Your answer
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