Black LGBTQ+ Legal Professionals Caucus Membership Application

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Please fill out this form to apply for the Black LGBTQ+ Legal Professionals Caucus. For questions, please email judi@lgbtbar.org.

First name *

Last name *

Email address *

Employer *

Title *

City *

State/Territory *

I affirm that I am a Black-identifying member of the LGBTQ+ community who is a legal professional or law student. *

Yes, I am, and would like to be added to the listserv.

No, I am not, and understand that I cannot be added to the listserv, but I would like to be informed about programming available to allies.

Required

OPTIONAL: How would you describe your gender identity? Select all that apply.

Cisgender female

Cisgender male

Nonbinary

Transgender female

Transgender male

Other (please specify below)

Prefer not to answer

If you answered Other, please specify your gender identity:

OPTIONAL: How would you describe your sexual orientation? Select all that apply.

Asexual

Bisexual

Gay

Lesbian

Pansexual

Queer

Questioning

Straight

Other (please specify below)

Prefer not to answer

If you answered Other, please specify your sexual orientation:

OPTIONAL: Please indicate the racial category or categories with which you primarily identify (select all that apply). Please note that this caucus is exclusively intended for legal professionals who are, at least in part, Black-identifying.

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latinx

Middle Eastern

Native Hawaiian or Other Pacific Islander

White

Other (please specify below)

Prefer not to answer

Would you be interested in helping with volunteer assignments for this caucus? *

Yes

Maybe

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