The Collective Coalition Membership Form
Please fill out to the best of your ability. This is for getting to know you!
Name
First Name
Last Name
The pronouns I use are
blanks
.
When is your Birthday?
-
Month
-
Day
Year
Add you to the Birthday list :)
Email
example@example.com
Phone Number
Please enter a valid phone number.
What is the best way to contact you?
What part of the LGBTQ+ community do you identify with?
Put what feels comfortable to disclose. This information will not be shared with your name.
What geographic region do you represent? City/neighborhood/school in San Diego
Have you ever participated in any coalitions/clubs? Feel free to list them.
What skills can you share with this coalition?
Data Collection skills
Social media engagement
Website maintenance
Public Speaking skills
LGBTQ+ Community engagement
Meeting Leadership/ feedback
Mentorship
Event Planning
Creativity
Other skills not listed? Talk yourself up. (ex: I am outgoing, I am a good observer, I take great notes, etc.)
What is your preferred learning style? Check all that apply.
Visual- Pictures/ graphs
Auditory- Lecture/ music
Physical- Hands on/ movement
Logical- Statistics/ numbers
Social- Collaboration/ team
Solitary- Independent/ individual
Verbal- Presenting/ writing
Why do you want to join this coalition?
Any other questions or feedback?
Submit
Should be Empty: