Thank you for your interest in Totally Outright 2019! Please complete the following questions with as much detail as possible, and then our Gay Men's Health Specialist will get back to you with any next steps. If you have any questions, please contact nhill@centreforsexuality.ca.

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* 1. What name do you use?

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* 2. What pronouns do you use? (ie. he/him, they/them etc.)

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* 3. Sexual Orientation

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* 4. Gender

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* 5. Age

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* 6. Address

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* 7. Phone Number

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* 8. Email Address

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* 9. How did you hear about Totally Outright?

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* 10. Why do you want to participate in Totally Outright?

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* 11. What are three things you would like to learn in Totally Outright?

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* 12. How would you describe your learning style(s)? What tools would help you learn best?

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* 13. Do you have any accessibility needs you would like us to know about? (ie. video captioning, ASL interpretation, etc.)

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* 14. What experience do you have working, volunteering, or otherwise being involved in your community?

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* 15. What are some of your interests?

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* 16. Totally Outright will be held over the weekend of May 4 and 5, with an evening session on Friday May 3. Are you able to attend these dates?

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* 17. Is there anything you need us to be aware of in order to eliminate barriers to you being able to participate in Totally Outright?

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* 18. Do you have anything else to add, or that you would like us to know?

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