FLUX General Member Application

FLUX Member Application & Profile
FLUX RAISES THE PROFILE OF THE TRANS* AND NON-BINARY COMMUNITY BY LEVERAGING SOCIAL EVENTS, CREATING SAFE SPACES, AND INNOVATIVE ADVOCACY INITIATIVES. YOU CAN LEARN MORE ABOUT US BY VISITING OUR WEBSITE
Name

First NameLast Name
Are you Trans or Non-Binary Identified?*
Pronouns*
Best Contact Number*

Area CodePhone Number
Emergency Contact Number

Area CodePhone Number
Name of Emergency Contact

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Which FLUX chapter are you interested in?*
Are you applying for a board position or volunteer? If so; which one?
I would like to be a member at large. I can help out from time to time.

YesNo, please send me an email for the next event.
E-mail*
Social Media Instagram
Social Media Facebook
Social Media Twitter
Social Media Snapchat
Profile Photo

Browse Files

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Upload your bio

Browse Files

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Upload your resume (Only if applying for a Board position)

Browse Files

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Some of our FLUX members have a presence and an affiliation with local or national organizations/groups. Please let us know about your affiliations & your role with each of them.
Affiliated Organization(s) or Groups
How did you hear about FLUX?*
Why do you want to be a member of FLUX?*
Have you attended a FLUX event before? If so, which event and tell us about your experience?*
What specific skills can you utilize for FLUX?
Signature

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Thank you for your interest in FLUX, we appreciate your time. Take a moment to follow us on social media @FLUX_AHF
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FLUX Member Application & Profile

Thank you for your interest in FLUX, we appreciate your time. Take a moment to follow us on social media @FLUX_AHF