Raise The Score Suggestion Form
Email address *
Suggested Municipality *
Municipality Type *
Link to the municipality's website or Wikipedia entry
Your Name *
Are you a municipal employee? *
Please specify the organization you represent. *
Best Phone Number to reach you with questions *
Instructions & IMPORTANT clarifications:
For any of the below questions, please list -- along with contact information if possible -- your answers.

IF YOU ARE NOT SURE: Reply "Unsure"
IF THERE ARE NO RESOURCES OF THAT TYPE: Reply "None"

You can press "Enter" to add a new line on all of the following questions.

Community LGBT Organization(s) providing direct service in this municipality *
List any LGBT Supportive Elected Officials whose involvement in pushing for LGBT-inclusive policy is likely. *
List any LGBT Supportive Appointed Officials whose involvement in pushing for LGBT-inclusive policy is likely. (ex. Solicitor, City Administrator, etc.) *
List any LGBT supportive clergy whose involvement in pushing for LGBT-inclusive policy is likely. *
List any LGBT business leaders, chambers, or business associations whose involvement in pushing for LGBT-inclusive policy is likely. *
List any Trans-specific service providers/organizations whose involvement in pushing for LGBT-inclusive policy is likely. *
List any potential barriers to LGBT-inclusivity in the municipality. *
Examples may include anti-LGBT politicians, anti-LGBT activist groups, ultraconservative media, anti-LGBT businesses, etc.
Any other information you want to share with us can be included below.
Any other community group(s) that would be helpful with this work (such as indivisible groups, LGBTQ social groups, etc.)?
Will you contribute and/or help raise funds to help cover the program costs in this municipality? (Select all that apply.)
Please attach a list of others who are jointly submitting this form. If you would like to submit something later, you can e-mail RTS@equalitypa.org.
A copy of your responses will be emailed to the address you provided.
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