PROUD Summer Program - Interest Form
The PROUD Summer Program for LGBTQ+ & Ally Youth ages 12 - 17 kicks off on Tuesday, June 16th online! Thanks to a partnership with the Santa Barbara Public Library we're excited to announce that world-renowned writer and transgender activist Kate Bornstein will attend our kick-off session led by this year's PROUD Youth Leaders. This program will meet online 4:30 - 6:00 PM every Tuesday and Thursday -- exploring LGBTQ+ youth fiction and graphic novels accessible online through the Library.

Please share some information with us, and we will reach out to you by Friday, June 5th with directions for official PROUD Summer Program Sign-Ups!

Questions? E-mail me at
~Patrick Lyra Lanier, LMFT
PPF Program Manager
Sign in to Google to save your progress. Learn more
Who are ya? ;) *
First Name (Chosen) *
We will only refer to you in person and in communications as this name.
First Name (Legal)
We will only use this name if aliens attack and it is an emergency situation
Last Name *
You are not required to share this, but knowing your pronouns means we can refer to you correctly!
School *
Please write your or your child's school's full name out and do NOT abbreviate. Example: Santa Maria High School (not SMHS).
City/Town *
What city or town do you current live in? Knowing your location helps us map who is interested in attending. Note: this program is open to youth from across the state of California, not just in Santa Barbara County.
Grade *
Youth, what grade are you in? Parents, what grade is your kiddo(s) in?
Preferred Mode of Contact
Let us know how we can best get in touch with you.
Clear selection
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pacific Pride Foundation. Report Abuse