BIPOC Outreach Interest

BIPOC Outreach Program (BOP) Interest Form

Please complete this form to refer yourself or someone else to the BOP.
Volcano Consulting, LLC in partnership with Prevention 305 and funded by Gilead, is in South Florida looking for hair care and beauty professionals. So, if you do hair, braid, are a barber, install laces and wigs, or color hair, do lashes...we want to hear from you!

BIPOC men are still disproportionately infected by HIV in the state of Florida. They are not at risk simply because of the color of their skin! One of the reasons for this is a lack of access to information and available services. This is sometimes linked to structural racism and/or implicit biases that keep information from reaching them. We need to break these barriers. We thank you for showing interest.
Submission Date*

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I am*

Your name*

First NameLast Name
Is this a hair care or beauty professional you use now or have used in the past?*

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Business/ Professional's Name
Contact Number

Area CodePhone Number
E-mail
example@example.com
Company Website
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Referral
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BIPOC Outreach Program (BOP) Interest Form