ADD YOUR NLAAD 2023 EVENT - REQUEST NLAAD POSTERS - REQUEST HIV TESTING KITS

REGISTER YOUR NLAAD EVENT

HELLO AND THANK YOU FOR PARTICIPATING OF NLAAD 2023 - 20 YEARS

Please provide us with your event information. If you are in need of support obtaining HIV tests please also complete the request form on the 2nd page of this survey

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* 1. IN RECENT YEARS HAVE YOU PARTICIPATED OF NLAAD WITH AN EVENT ORGANIZED BY YOUR ORGANIZATION? PLEASE CHECK ALL THAT APPLY

2017 "SUPERHEROES"

2018 "ENDING HIV IS EVERYONE'S JOB"

2019 "TOGETHER, LIVING WITH HIV OR NOT"

2020 "AT YOUR FINGERTIPS"

2021 "40 YEARS OF HIV EPIDEMIC"

2022 "YOUR CHOICE"

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* 2. YOUR 2023 EVENT TITLE / NAME OF YOUR EVENT

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* 3. HOST ORGANIZATION(S): PLEASE INCLUDE YOUR ORGANIZATION AND ANY PARTNER ORGANIZATION THAT YOU MIGHT BE COLLABORATING WITH

Your organization:

Partner Organization 1:

Partner Organization 2:

Partner Organization 3:

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* 4. CONTACT PERSON (THE PERSON WHO IS THE MAIN CONTACT FOR THE EVENT)

Name and title

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 5. WHAT TYPE OF EVENT ARE YOU ORGANIZING? PLEASE CHECK ALL THAT APPLY

INFORMATIONAL TABLE OR BOOTH

TESTING DAY / TESTING CAMPAIGN / TESTING FESTIVAL / TESTING EVENT

FOOD FESTIVAL

MUSICAL FESTIVAL

SPORT EVENT

BEAUTY PAGEANT / DRAG QUEEN SHOW / FASHION SHOW / DANCE

RELIGIOUS SERVICE OR EVENT

WEBINAR / WORKSHOP / EDUCATIONAL EVENT

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* 6. EVENT DESCRIPTION: PROVIDE A SHORT DESCRIPTION OF WHAT THE EVENT CONSIST OF. LENGHT OF THE PLANNED EVENT, ACTIVITIES THAT ARE PART OF IT, ETC

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* 7. EVENT DATE AND TIME (WHEN THE EVENT WILL HAPPEN) USE ONE FORM FOR EACH EVENT IF THERE ARE SEVERAL DAYS

Date / Time

Date

Time

AM/PM

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* 8. EVENT LOCATION (WHERE THE EVENT WILL HAPPEN)

Name of location or venue where the event will happen

Company (if the location belongs to a business, restaurant, theatre, parking lot, etc.

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 9. PLEASE ADD YOUR EVENT FLYER (IF YOU HAVE ONE)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 10. WILL THERE BE HIV TESTING AT YOUR EVENT? (are you planning of providing testing for HIV at your event?)

Yes

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* 11. WHAT IS THE TARGET NUMBER OF TESTING FOR THIS EVENT? (how many people you are expecting to test at your event?)

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* 12. ARE YOU REFERING PEOPLE TO PREVENTIVE SERVICES?

Yes

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* 13. ARE YOU DISTRIBUTING CONDOMS IN YOUR EVENT?

Yes

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* 14. ARE YOU REFERING PEOPLE FOR TREATMENT IN YOUR EVENT?

Yes

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* 15. DO YOU KNOW ABOUT U=U?

Yes

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* 16. WOULD YOU LIKE TO RECEIVE NLAAD 2023 POSTERS, IF YOU DO, PLEASE FILL THE SECOND PAGE OF THIS SURVEY

Yes

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* 17. DO YOU REQUIRE HIV TEST DONATION KITS FOR YOUR EVENT?
IF YES CONTINUE TO THE THIRD PAGE OF THIS SURVEY.

Yes

ADD YOUR NLAAD 2023 EVENT - REQUEST NLAAD POSTERS - REQUEST HIV TESTING KITS

REGISTER YOUR NLAAD EVENT

Question Title

* 1. IN RECENT YEARS HAVE YOU PARTICIPATED OF NLAAD WITH AN EVENT ORGANIZED BY YOUR ORGANIZATION? PLEASE CHECK ALL THAT APPLY

Question Title

* 2. YOUR 2023 EVENT TITLE / NAME OF YOUR EVENT

Question Title

* 3. HOST ORGANIZATION(S): PLEASE INCLUDE YOUR ORGANIZATION AND ANY PARTNER ORGANIZATION THAT YOU MIGHT BE COLLABORATING WITH

Question Title

* 4. CONTACT PERSON (THE PERSON WHO IS THE MAIN CONTACT FOR THE EVENT)

Question Title

* 5. WHAT TYPE OF EVENT ARE YOU ORGANIZING? PLEASE CHECK ALL THAT APPLY

Question Title

* 6. EVENT DESCRIPTION: PROVIDE A SHORT DESCRIPTION OF WHAT THE EVENT CONSIST OF. LENGHT OF THE PLANNED EVENT, ACTIVITIES THAT ARE PART OF IT, ETC

Question Title

* 7. EVENT DATE AND TIME (WHEN THE EVENT WILL HAPPEN) USE ONE FORM FOR EACH EVENT IF THERE ARE SEVERAL DAYS

Question Title

* 8. EVENT LOCATION (WHERE THE EVENT WILL HAPPEN)

Question Title

* 9. PLEASE ADD YOUR EVENT FLYER (IF YOU HAVE ONE)

Question Title

* 10. WILL THERE BE HIV TESTING AT YOUR EVENT? (are you planning of providing testing for HIV at your event?)

Question Title

* 11. WHAT IS THE TARGET NUMBER OF TESTING FOR THIS EVENT? (how many people you are expecting to test at your event?)

Question Title

* 12. ARE YOU REFERING PEOPLE TO PREVENTIVE SERVICES?

Question Title

* 13. ARE YOU DISTRIBUTING CONDOMS IN YOUR EVENT?

Question Title

* 14. ARE YOU REFERING PEOPLE FOR TREATMENT IN YOUR EVENT?

Question Title

* 15. DO YOU KNOW ABOUT U=U?

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* 16. WOULD YOU LIKE TO RECEIVE NLAAD 2023 POSTERS, IF YOU DO, PLEASE FILL THE SECOND PAGE OF THIS SURVEY

Question Title

* 17. DO YOU REQUIRE HIV TEST DONATION KITS FOR YOUR EVENT?IF YES CONTINUE TO THE THIRD PAGE OF THIS SURVEY.

* 17. DO YOU REQUIRE HIV TEST DONATION KITS FOR YOUR EVENT?
IF YES CONTINUE TO THE THIRD PAGE OF THIS SURVEY.