Be Proud! Be Responsible!

Be Proud! Be Responsible!

Are you a young man of color between the ages of 17 & 24 who has sex with men? Are you concerned about your Sexual Health and the Sexual Health of your friends?

The South Carolina HIV/AIDS Council needs your help!

Help Us Help You! Participate in a confidential interview & receive $50.00

Earn While You Learn! Participate in our Health Education Program & receive $100.00

How YOU Doin’? Return for a follow-up after 30 days & receive $50.00

Ask about opportunities to receive additional incentives!

Participant Information Form
(fill out the following form and we will contact you confidentially)

Name:

Street Address:

City:

State:

ZIP:

Phone:

Alternate Phone:

Email:

Date of Birth (MMDDYY):

Age:

If you were refered to this program, how did you hear about it?

What’s your preferred method of contact?

Will you need transportation?