Registration Form: #MeTooLGBTQ VIRTUAL Conference 2020

WHEN: October 15-17, 2020
WHERE: Virtual (via Zoom)

DESCRIPTION

The goal of the #MeTooLGBTQ conference is to increase culturally competent services for victims/survivors of sexual violence and relationship violence that identify as lesbian, gay, bisexual, transgender, or queer and to create space for LGBTQ+ survivors to connect with each other and community resources. This three-day conference is the only conference of its kind in the country outside of higher education and is the first step in a long-term solution, aiming to bridge the gaps between the LGBTQIA+ communities and spaces of healing and care for sexual and relationship violence.

This year’s theme focuses on resiliency and thriving, centering intersectional identities and approaches. The 2020 conference will filter its content through the dual lenses of anti-racism/racial justice and working with trauma during a pandemic.

Due to the ongoing pandemic, the 2020 conference has been shifted to a virtual platform, spread across three consecutive days. See below for the conference structure.

Registration is open to service/healthcare providers* and students who are invested in better serving LGBTQ+ survivors, as well as victims/survivors of sexual violence and community members that are invested in healing, community, and ending sexual violence. New this year, we are adding a youth track for attendees aged 13-18. Workshop tracks will allow attendees to participate in interactive trainings and presentations, hear directly from LGBTQ+ survivors of sexual violence, and receive valuable resources.

Registration provides access to the Zoom information and any digital conference material.

*"Service/healthcare providers" includes but is not limited to: mental health providers, clinicians, medical providers, survivor service providers, clergy, youth-serving professionals, and other front-line providers.

Course meets the qualifications for 4.0 total hours of continuing education credit for LMFT’s, LCSW’s, LPCC’s and LEP’s as required by the California Board of Behavioral Sciences. CEs are provided by North County Lifeline at no cost. North County Lifeline (Provider #129488) is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LCSWs, LPCCs, and LEPs. North County Lifeline maintains responsibility for this program/course and its content.

SCHEDULE

See the full conference schedule and structure here: https://sdpride.org/metoolgbtq/

ABOUT

The MeTooLGBTQ Conference is a collaborative effort of community organizations in San Diego, including: The San Diego LGBT Community Center, Center for Community Solutions, San Diego Pride, North County Lifeline, the Gender Phluid Collective, and the Copley-Price Family YMCA.

For questions: please email metoolgbtq@gmail.com

To register for this conference, please complete this form.

Registration Type *

Providers Student (higher education) Survivors and/or Community Members Youth (ages 13-18)

PROVIDERS: Please select the day(s) you would like to register for: *

Thursday, Oct 15 (general audience) - $20.00 Friday, Oct 16 (providers & students only) - $50.00 Saturday, Oct 17 (closed survivor space) - Sliding scale

Scholarship - Providers: Please click below if you would like to request a partial or full scholarship. No payment will be required today; a committee member will follow up.

Full scholarship requested Partial scholarship requested

STUDENTS: Please select the day(s) you would like to register for: *

Thursday, Oct 15 (general audience) - $10.00 Friday, Oct 16 (providers & students only) - $10.00 Saturday, Oct 17 (closed survivor space) - Sliding Scale

Scholarship - Students: Please click below if you would like to request a partial or full scholarship. No payment will be required today; a committee member will follow up.

Full scholarship requested Partial scholarship requested

SURVIVORS/COMMUNITY MEMBERS: Please select the day(s) you would like to register for: *

Thursday, Oct 15 (general audience) - Sliding Scale Saturday, Oct 17 (closed survivor space) - Sliding Scale

YOUTH: Please select the day(s) you would like to register for: *

Thursday, Oct 15 (general audience) Saturday, Oct 17 (closed survivor space)

Registration - Sliding Scale *

Survivors/community members and attendees of Saturday's survivor convening: Choose the amount you would like to pay for registration. Suggested amounts: $0 - $50.

REGISTRATION TOTALS:

Total registration amounts have been calculated into the field below based on your registration selections. Those requesting scholarships and those registering as Youth will not submit payment at this time; a member of our committee will be in touch with you shortly.

Payment information will be collected at bottom of form.

TOTAL - Registration *

Calculated from registration selections

Title

e.g. Dr, Rev, Rabbi, etc

Name *

First Name Last Name

Professional Suffix

If applicable

Organization

If applicable

BBS License Number & Type (For CEs only) or Student/Other Provider *

Include license number. Students, please type Student. Providers without a BBS license, please type N/A.

Phone Number *

Email *

example@example.com

ACCESSIBILITY

American Sign Language (ASL) interpretation services have been confirmed for this event. Additional accessibility accommodations, including English transcription, and visual content description services can be arranged for this virtual event with advance notice. We will provide ASL interpretation and English transcription through an online portal. Access to these services requires a computer and internet connection. To make an access needs request or to request additional information about the ASL accessibility at this event, please email melissa@sdpride.org at least two days prior to the event.

INFORMACIÓN SOBRE SERVICIOS DE INTERPRETACIÓN

Servicios de traducción en español/inglés pueden ser proporcionados con aviso previo para este evento virtual. Los servicios de traducción se proporcionarán en línea, y requiere tener acceso a una computadora y conexión a internet. Para pedir servicios de traducción o para solicitar más información, envíe un correo electrónico a melanie@sdpride.org al menos dos semanas antes del evento.

ACCESSIBILITY: Select the following if they apply to you. We will try to fulfill requests for other reasonable accommodations if submitted by September 30.

ASL required Interprete en Espanol es necesario/Spanish-speaking interpreter required Other

DEMOGRAPHICS

The MeTooLGBTQ Conference upholds values of nondiscrimination, equity, and justice, and does not allow discrimination on the basis of race, sexual orientation, gender identity, or expression.

We request demographic information from our attendees for our own assessment of accessibility and inclusivity.

The following demographic questions are optional.

Select Attendee's race/ethnicity (select all that apply)

Select Attendee's Sexual Orientation (select all that apply)

Lesbian Gay Bisexual Pansexual Queer Asexual Heterosexual Prefer Not to Say Not listed:

Select Attendee's Gender Identity (select all that apply)

Does Attendee identify as a victim/survivor of sexual and/or relationship violence?

Yes No Unsure Prefer not to say

Additional Donations:

We will be accepting this type of additional donation:

Sponsor an attendee:
- $50.00 will cover costs for one (1) attendee at this year's MeTooLGBTQ Virtual Conference, and will enable us to offer more scholarships to attendees that cannot pay. This is especially needed while many of our service organizations are facing financial uncertainties!

Donation - Sponsor an Attendee

$50.00 (One attendee) $100.00 (Two attendees) Other

TOTAL - Donations

Calculated from donation selections

TOTAL - Registration + Donations *

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#MeTooLGBTQ Virtual Conference 2020 Registration