Feel Free to Call Us
Contact Person: Suzanne Tait, Outreach Coordinator
Beautiful Gate Outreach Center reserves the right to deny requests. Beautiful Gate Outreach Center (BGOC) is a non-profit HIV/AIDS outreach ministry of Bethel African Methodist Episcopal Church. The mission of Beautiful Gate is to provide information, prevention strategies, and outreach assistance that educates, and empowers persons in the community while contributing to the eradication of this catastrophic disease. You have requested BGOC's participation in an event. Please complete this form in its entirety. The information you provide will allow us to ensure that we meet the needs of your event. Please submit your request no later than 2 weeks prior to your event.
Name of Event
Date of Event
Location of Event
Time of Event (start/end)
Set up Time
Target AudienceYouthTeensSenior CitizensAll Ages
Name of Organization
Organization Phone Number
Address of Organization
Requesting Services For: HIV/AIDS Education Speaker
Table Display with Information Will a table, two (2) chairs be provided? YES
HIV Counseling & Testing (requires an enclosed private room) I Understand and want HIV Counseling and Testing
Name of Contact Person
Contact Email Address
Alternate Contact Person
Alternate Contact Phone Number
Alternate Email Address
* If you are requesting HIV counseling and testing be performed, due to the high level of confidentiality required a private enclosed area is needed. It is imperative that rooms designated for counseling and testing are restricted from use by anyone else during the time that testing is taking place. A separate waiting area for attendees of the event who want to be tested is also required. Refreshments for those who want to be tested must be provided by your organization.
Please use this area to provide a full description of your event (including the names of other co-sponsors and participants). Please include the overall goals of the event.
Acknowledgement and agreement: I understand that Beautiful Gate Outreach Center performs HIV Education, Counseling &Testing. I also understand that information regarding sexual behavior and drug use is discussed in the information provided. I am noting below any and all special requests regarding information provided in open education sessions.
Please enter the letters:
Due to the high volume of requests received,BGOC is unable to agree to attend all events.
Please submit your request no later than 2 weeks prior to your event.
Copyright © Beautiful Gate Outreach Center
All rights reserved. Disclaimer
Designed By: Visionary Insight Productions