We Queer About You!
Nyob Zoo!

We want you to know that we Queer (care) about you, and we would love to get to know you better. Please take about 5 minutes to go through this survey to help us better understand how we can serve you!

Queer Coordinators | Leader Thao & Annie Moua
Email *
Have you been apart of Cia Siab Inc. programs before? *
Name *
Race *
Required
What is your age range? *
What school do you attend? *
What grade are you in? *
What is your address? *
Which gender do you most identify as...
Clear selection
Preferred way of communication? *
We are sending out care packages, would you like one? *
We are also offering condoms in our care packages would you like some?
Clear selection
Feedback? (anything future programs, events, or ideas that you would like to see happen in the LGBTQ+ program)
Submit
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