Interest in LGBTQ+ Support Services

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The Youth Development Office (YDO) in EGUSD provides district-wide support to EGUSD’s LGBTQIA+ students and can help connect you with a variety of services and resources. Please fill out the following form indicating how we can support you!

For students

Confidentiality: The information shared on this form will be kept strictly confidential.

Any EGUSD staff member or family member may fill this form out on behalf of a student.

For any questions, please reach out to Program Specialist, Larrah Feliciano at lfelicia@egusd.net.

Email *

Record my email address with my response

Email: *

Affirmed Name (First and last) *

Student's name as it appears on Synergy, if different from above. (First and last)

Pronouns: *

School or department: *

I am/will be an EGUSD student:

Yes

No, I am a staff member.

Perm ID:

I am interested in learning about (select all that apply): *

Gender Support Plan (affirming gender identity agreement on campus or Synergy name change/gender marking change)

Gender affirming products

LGBTQ+ protections in EGUSD

Information on GSA (Gender & Sexuality Alliance) Club on campus

YDO's LGBTQ+ Student Advisory Council

Required

Best way to contact (phone number or email): *

Any additional questions or comments: *

Thank you for your submission. We will get back to you as soon as possible. If you do not hear from us within a week, please contact the Youth Development Office. Thank you!

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