EmailMe Form - Leadership Team Application

Leadership Team Application
2011-2012 Application

Iowa Pride Network’s Leadership Team is a diverse group of leaders from colleges and high schools all over Iowa. Thanks for applying!

First Name *

Last Name *

Address *

City *

Zip Code *

Email Address *

Primary Phone Number *

Do we need to be discreet when contacting you? *

Yes

Date of Birth (MM/DD/YY) *

School you attend *

Name of GSA or LGBTQA-related organization *

Your GSA's Faculty Advisor *

Advisor's Email *

Advisor's Phone Number

Year in School (2011/2012)

Gender

Sexuality

Ethnic Background

References

Please provide contact information for at least two references who know about your work with an LGBTQ youth and/or who can attest to your abilities as a youth leader.
It can be a peer, friend, teacher, or anyone else.

Reference 1
Name *

Relationship to you *

Phone *

Email *

Reference 2
Name *

Relationship to you *

Phone *

Email *

Open-Ended Questions

Please answer the following questions concisely and completely.

1) Please describe your involvement and experiences with the LGBTQ movement and any other movements or anti-oppression work you have been a part of.

2) Why are you interested in serving on the Iowa Pride Network Youth Council or Leadership Team? What would you be able to contribute to the Youth Council or College Leadership Team?

3) What issues have you seen on your campus that you would be interested in addressing this school year (i.e. slurs & name calling, gender expression, unsupportive administration etc.)?

4) In your opinion, what are the greatest challenges facing GSAs or LGBT college organizations, and youth fighting homophobia, transphobia, and biphobia in schools and/or colleges?

5) Share some ways that racism, classism, sexism, and other oppressions have affected you and your activism?

Any additional comments?

Image Verification
	Please enter the text from the image: [Refresh Image] [What's This?]

EMF HTML Contact Form

Report Abuse