* 1. In what zip code is your home located? (enter a 5-digit ZIP code, for example 07701 or 07728)

* 2. Please answer the questions below to help us learn more about you.

  Yes No
Are you 13-19 years old?
Are you younger than 13?
Are you older than 19?
Do you identify as LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning)?
Do you identify as an ally or friend?
Are you or your friend(s) out?
Are you out to family?
Are you out to friends?

* 3. We have some questions about education and safety.

  Yes No Uncertain
Do you and/or your friend(s) have access to information on LGBTQ health and safety?
Is your home safe?
Is your school safe?
If your neighborhood safe?

* 4. Do you know about the 2nd Floor Hotline?
The 2nd Floor hotline number is 1-888-222-2228 and their web address is: 2ndfloor.org

* 5. Some questions about LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning) events for teens:

  Yes No
Do you participate in LGBTQ specific activities?
Do you attend LGBTQ specific events like Pride?
Do you have a GSA (Gay-Straight Alliance) at your school?
Would you attend a monthly LGBTQ event in Red Bank?
Would you bring friends to such an event?

* 6. How do you travel to events with other LGBTQ teens?

* 7. If you don't attend LGBTQ youth events, why not (you can check multiple answers)?

* 8. How do you get information relating to LGBTQ youth, issues, and activities?

* 9. Do you think you/your friend(s) parents could use support or information about LGBTQ youth and issues?

* 10. Is there anything you'd like to share with us? Anything we missed?

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