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Register for Sharing Our Stories (Sun 1 Dec 2024)
*
1.
Your name
(Required.)
*
2.
Your e-mail
(Required.)
3.
Your mobile number (optional—to send a reminder text)
4.
Where are you based?
New Zealand
Australia — ACT
Australia — NSW
Australia — NT
Australia — QLD
Australia — SA
Australia — Tas
Australia — Vic
Australia — WA
Another country (please say)
*
5.
Are you a person living with HIV?
(Required.)
Yes
No
Unsure
*
6.
I am interested in taking part in the closed workshop 'Telling your stories safely' (8AM-9.30AM on Sun 1 Dec before the main event).
(Required.)
Yes
No
7.
If you are living with HIV, in what year were you diagnosed?
8.
What is your current gender?
Man
Woman
Nonbinary or genderfluid
Agender
Another gender
9.
How do you describe your sexuality?
Heterosexual
Gay
Lesbian
Bisexual
Queer
Asexual
Another sexuality
10.
Are you Indigenous in your country of origin?
Yes
No
11.
Are you from a culturally diverse background in your country of residence?
Yes
No
12.
Do you need any assistance or accommodations to enable you to take part in the webinar?
No, thank you
Yes, please (give details)
13.
Would you like to be added to our monthly mailing list?
Yes
No
14.
[Optional] What would you like to see or hear at the Sharing Our Stories webinar?
Current Progress,
0 of 14 answered
