Year of birth
Concerning gender identity, what best describes your gender? Are you:
What sex were you assigned at birth?
This is typically the sex that is listed on your birth certificate.
Please select your religious or non-religious affiliation:
Agnosticism or Atheism or Secular
Christianity - Baptist
Christianity - Evangelical
Christianity - Jehovah's Witness
Christianity - Lutheran
Christian - Methodist / Wesleyan
Christianity - Mormon
Christianity - No particular denomination
Christianity - Pentecostal
Christianity - Presbyterian
Christianity - Protestant
Christianity - Roman Catholic
Christianity - Seventh-Day Adventist
Christianity - United Church of Christ
Christianity - Other
Native American religion
Spiritual, but not connected to a particular faith
Do you have any accessibility needs and/or require any accommodations?
What made you interested in Encircle?
Please answer the following question however you would like to. I believe being LGBTQ/SSA is:
My family believes being LGBTQ/SSA is:
My friends believe being LGBTQ/SSA is:
My neighbors believe that being LGBTQ is:
Would you feel more comfortable or safe joining a cyber Encircle community?
If so, what resources or supportive services do you hope the cyber community could provide?
Do you have any concerns about being discriminated against at Encircle?
If so, how do you think Encircle could best prevent this kind of discrimination?
For LGBTQ/SSA Individuals:
Please fill out this section ONLY if you are LGBTQ/SSA-identified. If you are NOT LGBTQ/SSA, please fill out the next section.
What LGBTQ/SSA groups/activities/events do you wish were available?
How safe do you feel in Utah as a LGBTQ/SSA-identified individual?
For Non-LGBTQ/SSA Individuals:
PLEASE FILL OUT THIS SECTION ONLY IF YOU ARE NOT LGBTQ/SSA-IDENTIFIED. IF YOU ARE LGBTQ/SSA, PLEASE FILL OUT THE PREVIOUS SECTION.