Vox Interest Survey

1. VOX: Voices for Planned Parenthood

Pro-choice students all over South Florida are educating the university community about reproductive health and rights to translate increased awareness into pro-choice activism on campus, and to serve as a coalition partner to state, national, and international reproductive efforts through VOX chapters.

VOX: Voices for Planned Parenthood is a program to educate and mobilize students and youth in support of reproductive health and rights. VOX groups across the country organize public events, educate their peers, support their local Planned Parenthood health centers, and mobilize students and other young people to speak out for reproductive rights and access to reproductive health services.

Fill out this survey to let us know how you would like to get involved!

1. Please provide your contact information.

Please provide your contact information. Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

2. Please answer the following:

Please answer the following: Where do you attend college?
Undergraduate or graduate?
Year?
Major?

3. What topics are you most interested in? (check all that apply)

What topics are you most interested in? (check all that apply) Abortion Access

Access to Health Care

Birth Control Access

Sex Education

Other (please specify)

4. In what ways are you interested in getting involved with Vox? (check all that apply)

In what ways are you interested in getting involved with Vox? (check all that apply) Being an active member of the group (campus outreach, event planning, etc..)

President

Vice President

Secretary

Treasurer

Committee Chair

Attending Events (movie nights, meetings, discussion groups, etc..)

Other (please specify)

5. Vox will be hosting informational and planning meetings in the next few months. When would you be able to attend? (check all that apply)

	Morning	Afternoon	Evening
During the summer	Vox will be hosting informational and planning meetings in the next few months. When would you be able to attend? (check all that apply) During the summer Morning	Afternoon	Evening
Before fall semester starts (early August)	Before fall semester starts (early August) Morning	Afternoon	Evening

Other (please specify)

6. Are you interested in working on Vox projects during the summer?

Are you interested in working on Vox projects during the summer? Yes

Other (please specify)

7. What is your preferred method of communication? (check all that apply)

What is your preferred method of communication? (check all that apply) Email

Phone

Facebook

MySpace

Other (please specify)

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