GLSEN LA Chapter Member Interest

GLSEN LA Chapter Member Interest

Chapter Members must complete a background check conducted by GLSEN every 2 years. Please expect a GLSEN LA Chapter Member to respond to your Interest Form within 5-7 business days.
GLSEN LA is open to Chapter Members 18 years of age and up!
Your Information
Full Legal Name*

First NameLast Name
Preferred Name*

First NameLast Name
Pronouns*
Email Address *
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Have you completed a background check within the last two years?*
If you are selected to join as a Chapter Member, you will be required to complete a background check every 2 years. It is not required to have already completed a background check at the time of this interest form.
I agree to complete a background check every 2 years via GLSEN's policies and procedures.*
Applicant Questions
Current or Most Recent Occupation
Please upload your resume (.pdf format only)

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Chapter Members will typically serve a two-year term and are a Chapter Member or a Chapter Member Leader. Expectations of your time commitment as a Chapter Member include:
- Attending 2 hour monthly Board Meeting on Zoom
- Attending a minimum of 2 quarterly Chapter events
- Timely responses to emails
Please take the time to read about the Open Chapter Roles & Responsibilities
I am applying for the following Chapter Roles (check all that apply):

TreasurerSecretaryYouth Programs Co-LeadPolicy LeadSupporting Chapter Member
Please explain why you would be a good fit for the position. (300 words max per position)
Why do you want to be involved with GLSEN LA and what do you hope to contribute as a Chapter Member? (300 words max)
How did you hear about GLSEN LA?
If there is anything else you would like to provide (e.g. link to online portfolio, website, LinkedIn, social media, etc.) or anything else you'd like us to know, please add it here.
If you were referred to the application/have any relationship with a current or former GLSEN LA Chapter Member, please write their name(s) below and the nature of your relationship:
I agree to complete an Interview (30 minutes-1 hour) on Zoom with GLSEN LA Chapter Members.
I certify that the information in this form and any attached documents is true and correct.
Please type your full name below.
Date signed

MonthDayYear
One last thing! Please note that your interest form will not be submitted until you click the "Submit" button below.

We send out email newsletters about once a month, sometimes more frequently depending on if there is an event coming up. You are not required to sign up to receive our email newsletters in order to submit your interest to become a Chapter Member.
I would like to have the following email address added to GLSEN LA's newsletter/list serve. I understand that I may unsubscribe at any time, and this will not impact my ability to become a Chapter Member.
example@example.com
Should be Empty: