Are you a Safe Space?
This survey will determine if you are qualified to be on a list called the Certified Safe List for the queer community. It's a list of local businesses and establishments that happily accept, support, and protect the queer community. Every place gets a Certified Safe sticker to put up in its space. Being a safe space for the queer community means more than just accepting money and business from the queer community. Being a faithful ally means more than just words. This survey will ask how you intend to show up for our community and your LGBTQ+ patrons.
How willing are you to put effort into learning about and respecting preferred pronouns? Remember that most people do not expect perfection, just effort.
*
Not willing
1
2
3
4
5
6
7
8
9
Very willing
10
1 is Not willing, 10 is Very willing
If violence against any LGBTQ+ individual happens in your space, how likely are you to ask the aggressor to leave? For example, if you hear someone using slurs or threatening someone?
*
Absolutely not
1
2
3
4
5
6
7
8
9
Yes without question
10
1 is Absolutely not, 10 is Yes without question
Are you willing to stay up to date with LGBTQ issues and topics?
*
Not at all
1
2
3
4
5
6
7
8
9
Yes!
10
1 is Not at all , 10 is Yes!
Are you willing to learn more about LGBTQ+ culture to be a better Ally?
*
Definitely Not
1
2
3
4
5
6
7
8
9
Please teach me!
10
1 is Definitely Not , 10 is Please teach me!
Are you willing to support local queer groups, artists, and organizations? For example, will you display flyers, allow meetings within your space, or attend events if possible?
*
Not at all
1
2
3
4
5
6
7
8
9
Always
10
1 is Not at all, 10 is Always
How willing are you to put up signals for LGBTQ+ individuals? For example, our certified safe space sticker, a pride flag, or a pride sticker? Remember that small things make all the difference.
*
Not at all Likely
1
2
3
4
5
6
7
8
9
Extremely Likely
10
1 is Not at all Likely, 10 is Extremely Likely
Trans Rights? Marriage Equality?
*
Yes
No
In your own words, why do you think you are a Certified Safe Space for the LGBTQ+ community?
*
Please name your business or organization here and also a shipping address so we can send you your sticker.
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: