Hispanic Black Gay Coalition (HBGC) Inquiry Survey

1. What service(s) do you feel Boston lacks for the Black and Latino LGBT community? Please check all that apply.

What service(s) do you feel Boston lacks for the Black and Latino LGBT community? Please check all that apply. "Coming Out" Counseling Academic Mentoring Advocacy (GLBT Rights/Equality) Community Service Debt/Credit Card Solution Drug Rehabilitation	Gay Sports League HIV Counseling & Support Religious/Spiritual Guidance Sex Addiction Counseling STD Testing/Prevention Support for LGBT Parents/Relatives
Other (please specify)

2. What service(s), if provided, would you personally be interested in taking advantage of?

What service(s), if provided, would you personally be interested in taking advantage of? "Coming Out" Counseling Academic Mentoring Advocacy (GLBT Rights/Equality) Community Service Debt/Credit Card Solution Drug Rehabilitation	Gay Sports League HIV Counseling & Support Religious/Spiritual Guidance Sex Addiction Counseling STD Testing/Prevention Support for LGBT Parents/Relatives
Other (please specify)

3. On the follow scale (1 meaning not interested at all, 10 meaning extremely interested), please rate how interested you would be in an LGBT service organization that caters to the Black and Latino community.

On the follow scale (1 meaning not interested at all, 10 meaning extremely interested), please rate how interested you would be in an LGBT service organization that caters to the Black and Latino community. 1

4. In deciding to participate, what age group would make you feel most comfortable?

In deciding to participate, what age group would make you feel most comfortable?

5. If you were to join, what type of seminar topics (discussions led by experts) would you be interested in?

If you were to join, what type of seminar topics (discussions led by experts) would you be interested in?

6. Are you interested in taking on a leadership and/or outreach role with our organization.

Are you interested in taking on a leadership and/or outreach role with our organization.

7. Have you ever been involved with an LGBT organization

Have you ever been involved with an LGBT organization Yes

Unsure

8. THIS QUESTION IS OPTIONAL: If you answered "Yes" or "Maybe" to question 6 OR would like to learn more about HBGC, please provide your contact information for follow-up.

THIS QUESTION IS OPTIONAL: If you answered "Yes" or "Maybe" to question 6 OR would like to learn more about HBGC, please provide your contact information for follow-up. Name:
Email:
Phone #:
Age:
Occupation:

9. Tell us anything else on your mind:

Tell us anything else on your mind:

Hispanic Black Gay Coalition (HBGC) Inquiry
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