Please answer these brief questions so we can get an idea of what your school culture is and how we can help.

Name:

Title:

Address:

Address2:

City:

State:

Zip:

Phone:

Email:

School Name:

Does your school currently have HIV/STD prevention programs?:

If so, briefly describe:

Do you think your school could do more towards prevention?:

If so, what do you think is lacking?:

Do you feel that HIV and STD's have impacted your school?:

If so, how?:

Which best describes your school's culture regarding sex?: