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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 day(s) are you mostly free for meetings and events? (Next to day(s) checked put time period available- ex: after 4pm, all day, before 12am, between 5-8pm)
    Monday        Tuesday
    Wednesday  Thursday
Friday        Saturday
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?
What do you hope to learn from us?
How did you hear about us?
Any other questions or feedback?
Should be Empty:

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The Collective Coalition Membership Form