Queer, Trans, & Allied Student Summit of the Central Coast — Fall 2022
Thank you for registering for the student summit. If you have any questions or concerns, contact us at (831) 427-4004, CoordinateSummit@gmail.com or visit the summit website.

Everyone who attends the Summit must complete this registration form.

Registration from Oct 4-5 will be accepted.

Registration Oct 6-8 will be accepted as “Same-day Registration”

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Email *
First Name *
Last Name *
Phone Number
Should we be discreet when contacting you? *
Required
Registration
As it will appear on your name tag (Name, Pronouns, School/Student Club or Organization).
Preferred Name 

Name as you would like it to appear on your name tag
 *
Last Name (optional)
Pronouns
School, Student Club or Organization *
Pick a lanyard for the day of the event! *
Pick a pin for the day of the event! *
First 150 students to register get an enamel pin *
First 150 students to register get a T-shirt!  *
Captionless Image
Required
The following questions help us understand how to better serve our diverse youth population. This data will only be used by the Safe Schools Project and will not affect your eligibility to attend the conference.
Race or Ethnicity *
Required
Genders *
Required
Sexualities *
Required
What year are you in school now? *
Required
What city are you from?
Monterey County
San Benito County
Santa Cruz County
How are you arriving to the summit?
 *
Required
Food & Accommodations
I need the following type of food accommodations
 *
What types of foods would you like to see at the Summit (These are not guaranteed)?

What foods for Breakfast?

What foods for Lunch?

What Snacks? *
Accommodations
 *
Required
Emergency
Name of Emergency Contact *
Emergency Contact Phone Number *
Where did you hear about the Fall 2022 Queer, Trans & Allied Student Summit of the Central Coast? *
Required
What topics would you like to see as workshops at student summits like this one? *
Required
What do you wish to get out of the summit? *
Required
What do you want to do with what you will learn from this summit? *
Required
Community Service Hours
Students who attend the Queer, Trans, and Allied Student Summit may be able to earn school credit for participating in the summit. If your school has a community service, volunteer, or similar requirement, talk to your school counselor to see if you can earn credit for attending the summit. Be sure to email any forms to be signed by Summit staff to CoordinateSummit@gmail.com.

I’d like to start receiving the “Queer Youth Updates” electronic newsletter that includes local and regional LGBTQIA+/Ally events, news, resources, scholarship information and more. *
Required
Thank you for registering for the Fall 2022 Queer, Trans & Allied Student Summit  - See you soon!
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