TSSSA Registration Form

Two-Spirit Safe Space Alliance
Name

First NameLast Name
Pronouns (She/Her/He/Him/They/Them/etc.)
E-mail
example@example.com
Phone Number
Grade in School

9th Grade10th Grade11th Grade12th Grade
Birth Date

MonthDayYear
High School
Zip Code
Personal Identity (Can select more than 1)

Two-SpiritTransgenderAgenderLesbianGayBisexualPansexualQueerAsexualAllyPrefer Not to SayOther
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.
What is your biggest motivation to join TSSSA?
Please select which events you are interested in attending:

Welcome to TSSSA Meeting - September 25thIndigenous People's Day Celebration - October 9thAdvocacy and Know Your Rights Workshop - October 23rdTwo-Spirit History and Game Night - November 13thArts and Crafts Night (Gift Making) - December 11thRoller Skating at Oaks Park - December 1st
Should be Empty:

Two-Spirit Safe Space Alliance