LGBTQ+ Online Community Input Form

This form is used to provide community input on Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ+) issues that are important to you. This form is not a police report, nor is it designed to replace calling 911. If you would like, you can fill out this form anonymously, however by being anonymous it will not allow the LGTBQ+ Liaison Officer to respond and assist you with your topic.

Please check the applicable topic:
Would you like to be contacted by the BPD Liaison Officer regarding the information you provided?
Your Name
Address
CAPTCHA
8 + 6 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.