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JHOUSE

Welcome to JHouse member and chat room, I


________________________ is a new member at JHouse
chat room and I am happy to be a part of this company.

Signed:____________________________

Signed___________________________
Manager (Andrew Vickers)

We love you and we are all happy that you are a member
of our team.

Thank you

JHOUSE
NAME

TELEPHONE #

ADDRESS

SIGNATURE

JHOUSE
How many male and female offices
MSM

BISEXUAL

LESBIAN

BISEXUAL

JHOUSE
Questionnaire
Please place a tick in the box provided beside each
question for your answer.

1. Are you a MSM?

Yes

2. How many partners do you have?


3. Do you drink alcohol?

No
Yes

Yes

No

4. Do you drink alcohol when having sex?


5. Do you have HIV?

Yes

No

Yes

No

No

6. What would you do if you were HIV Position or have any other STDs
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
7. How much do you love yourself? __________________________________

8. Would you get married to your mate?

Yes

No,

If yes, why

_____________________________________________________________
_____________________________________________________________
and if No, why? _______________________________________________
_____________________________________________________________
_____________________________________________________________
9. Does anyone call you names?

Yes

10.Are you sorry about the life that you are living?

No
Yes

No,

if yes why, ___________________________________________________


_____________________________________________________________
_____________________________________________________________

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