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Polyamorous NYC is an organization designed specifically to serve the needs of the polyamorous Gay, Lesbian, Bi & Trans Community. If you would like to learn more and be kept up to date about upcoming events, please fill in your contact information below and you will be added to our Announcement email list.

If you would like to learn more about heterosexual-focused polyamorous organizations in the New York City area, Polyamorous NYC recommends TriState Poly.

You are under no obligation to fill out anything more than you are comfortable with. The information that you provide will only be used for the purposes of the group and the group alone. No individual personally identifiable info will be sold or traded to any organization other than Polyamorous NYC, TriStatePoly and/or the two New York City Polyamory E-mail Lists. The two primary purposes of this form are 1.) to use as a contact list to keep Polyamorous NYC members informed about upcoming events and 2.) to keep generalized statistical information on the demographics of the group.


Note: Field names in Bold are the only required fields.

 

FIRST NAME

LAST NAME

EMAIL

GENDER
Male
Female
Transgender Specify:
Intersex
Androgenous
Other Specify:

ADDRESS

CITY

STATE

ZIP

IN ADDITION TO THE ANNOUNCEMENT EMAIL LIST, HOW WOULD YOU LIKE TO RECEIVE INFORMATION ABOUT POLYAMOROUS NYC?
Polyamorous NYC Discussion Email list
Polyamorous NYC Town Hall Email list
Snail Mail (Home Address)
Telephone

PHONE #1
PHONE #2

SEXUAL ORIENTATION: (check all that apply)
Lesbian/Gay
Bisexual
Undefined
Queer
Straight ally
Polyamorous
Nonmonogamous
Monogamous ally
Other:

CURRENT ROMANTIC STATUS
Single
Couple
Triple
Quad
5+

OUT RATING
Out to everyone
Out to close friends
Discreet
Completely closeted

ADDITIONAL COMMENTS

 

 
 
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