FLUX Member Profile

FLUX Member Application & Profile
FLUX AIMS TO RAISE THE PROFILE OF THE TRANS* AND GENDER-NONCONFORMING COMMUNITY BY LEVERAGING SOCIAL EVENTS, CREATING SAFE SPACES, AND INNOVATIVE ADVOCACY INITIATIVES.
Are you Trans or GNC Identified? *
Name

First Name Last Name
Pronouns
Best Contact Number *

Area Code Phone Number
Emergency Contact Number *

Area Code Phone Number
Name of Emergency Contact

First Name Last Name
Date of Birth *

Month Day Year
Date
Age
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
FLUX Chapter *
Are you applying for a board position? If so; which one?
E-mail *
Social Media Instagram
Social Media Facebook
Social Media Twitter
Social Media Snapchat
Profile Photo

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Some FLUX members are a part of other organizations or operate one. Please let us know about your affilliations & your role with each of them.
Affiliated Organization(s)
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 what did you like about it?
What specific skills can you utilize for FLUX?
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FLUX Member Application & Profile