2021 Program RSVP for Pomona Pride Center Events

Please fill out the form below to RSVP to one or more of our scheduled events. Thank you in advance for your cooperation.

Name *

First Name Last Name

E-mail Address (you will be added to the Pride Center email list) *

example@example.com

Phone Number / Text Messaging

I am interested in the following "Scheduled Programs/Events" *

Pooch & Coffee at the park (1st Saturday of Month) Pomona Pride YOUTH Group (3rd Wednesday of the Month) FRIENDS & ALLIES Support Group (4th Tuesday of the Month) PARENT & FAMILY Support Group (Last Wednesday of the Month) QUEER & TRANS Support Group - COMING SOON! Queer WOMEN of Color Support Group - COMING SOON! SENIORS Support Group (4th Saturday of the month) Gay MENS Support Group COMING SOON!

How would you like to be sent program or event details?

TEXT me the info. E-MAIL me the info.

What is your Sexual Orientation?

Lesbian Gay Bisexual Straight Questioning

Other Sexual Orientation / Self Describe:

Gender Identity

Female Male Trans Female Trans Male Genderqueer/Gender non-Conforming Queer Non-binary/third gender Two Spirit Prefer to Self Describe

Other Gender Identity:

What is your age?

12-17 18-24 25-34 35-44 45-54 55 and older Prefer not to answer

Are you a Veteran/Military

Yes No

Do you have a disability?

Yes No

Primary Language

Ethnicity

Hispanic/Latino/a/x Non-Hispanic

Race

White/European Native American or Alaska Native Asian Black/African American Hawaiian or Pacific Islander Other

Anything you would like to add or suggestions for programs and or events?