Equality Virginia's Safe Schools Action Network Intake Form

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Thank you so much for your interest in joining EV's Safe Schools Action Network! We hope this space provides you the opportunity to get involved in advocacy for transgender and nonbinary students, get any questions you may have answered, and connect with others who are doing this work across the state.

Before we get you added to our network, please take a few minutes to answer the following questions. This information will help EV identify the diverse needs of folks across the state and inform our response and resourcing efforts. If you have any questions as you complete the form, please feel free to email Kyleigh Hynes (Safe Schools Coordinator) at khynes@equalityvirginia.org.

First Name: *

Please share the first name that you go by, regardless of it is the same or different from your legal first name.

Last Name: *

Please share the last name that you go by, regardless of if it is the same or different from your legal last name.

What are your pronouns?

Please note that this question is optional. For more information about pronouns and why they matter, please visit this GLSEN resource: https://www.glsen.org/activity/pronouns-guide-glsen

Email address: *

Please share the email address where you would like to receive Safe Schools Action Network emails.

Which region of Virginia do you live in? See this map for regional breakdowns: https://bit.ly/VA_regions *

This information will be used to ensure that we are reaching and adequately resourcing folks from across the state.

Central

West Central

Southside

Hampton Roads

Eastern

Southwest

Northern

Valley

What county, city, or town do you live in?

Please note that this question is optional. This information will be used to ensure that we are reaching and adequately resourcing folks from across the state, as well as to connect you with other advocates in your area should you wish to do so.

I am a... *

Please choose all that apply to you. This information will help us get a sense of what brings you to this work and potentially connect you with other advocates.

Transgender and/or nonbinary student in a Virginia public school division

Transgender and/or nonbinary adult currently living in Virginia

Parent/guardian to a transgender and/or nonbinary student

Relative (sibling, grandparent, cousin, etc.) to a transgender and/or nonbinary student

Friend/ally to transgender and/or nonbinary students

Educator in a Virginia public school division

Administrator in a Virginia public school division

Specialized Instructional Support Personnel (counselor, school social worker, library media specialist, etc.) in a Virginia public school division

School board member for a Virginia public school division

Other:

Required

How would you describe your race and/or ethnicity?

Please note that this question is optional. This information will be used to inform an intersectional approach to this advocacy work, as well as to facilitate connections between people of color of all backgrounds should they wish to form affinity spaces within this work.

Do you have any language or accessibility needs that you would like to make sure we are aware of?

Please note that this question is optional. This information will be used to ensure that we are providing content to you that you are able to access and consume more easily.

Has your school division fully adopted a trans-affirming policy? *

Yes

I'm not sure

Other:

Please describe your current needs surrounding this issue. What do you hope to gain from joining this network? *

Examples can be: advocacy support, education/trainings, opportunities to share my story, connection with others, ways to take action, etc.

Are you connected to and/or involved with any other LGBTQ-focused groups or organizations in Virginia? *

These can include organizations like Side by Side or He She Ze & We, regional Equality groups (i.e. Equality Loudoun, Equality Stafford), or local PFLAG chapters (i.e. PFLAG Blue Ridge, PFLAG Floyd), among others.

Is there anything else that you would like to share with us or think it's important that Equality Virginia knows?

Please note that this question is optional.

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