Introduction

Welcome to the SIlver Rainbow LGBTQ Club Survey!  

Prior to our first meeting on September 29, we want to hear from you!  We want to make the most out of our first meeting together and make plans for fun and productive activities that match your interests.  We have created a short, anonymous, ten question survey.

If you cannot make it to the September 29 event, we still value your feedback as we look forward to meeting everyone in the 757 interested in our group in the near future.

Thank you for your time.  We look forward to meeting you!

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* 1. Enter your age as of your last birthday

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* 2. What is your gender identity?  (Please mark any/all that apply)

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* 3. What is your sexual orientation?

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* 4. In what city do you live?

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* 5. Please enter your five digit zip code

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* 6. Do you feel you have a support network of at least one person you can go to in the event of an emergency?

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* 7. If you answered 'yes' to question 6, please identify whom you consider to be part of your personal support network?  (Please check any/all that apply)

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* 8. As you age, how important are the following issues?  Please rank each issue as it applies to your situation.

  Extremely Important Very important Somewhat important Not very important Not at all important
Housing 
Finances
Health Care
Social Isolation
Legal Issues
Going 'back in the closet'

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* 9. What types of activities would like to see the Silver Rainbow group produce?  Please select any/all that interest you.

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* 10. Would you be interested in getting involved and help plan events and other activities of the Silver Rainbow Group of Hampton Roads?

0 of 10 answered
 

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