PFLAG Connects Sign-up Sheet - Formulario
Please fill out these questions to the best of your ability. This information is gathered for intake purposes only and will not be shared with anyone. Once you submit this form, we will send you an email the morning of the meeting with instructions on how to join the meeting.
Por favor responda estas preguntas lo mejor que pueda. Esta información es para uso interno y no sera compartida con nadie. Una vez que envie este formulario, le enviaremos un email la mañana del dia de la reunión con instrucciones para conectarse.
* Required
Email address
*
Your email
First Name, Last Initial - Nombre, Inicial del Apellido
*
Your answer
Personal Pronouns - Pronombres Personales
Your answer
How did you find out about this virtual support group? - Cómo se entero de este grupo de ayuda virtual?
Email List / Lista de Email
PFLAG Omaha Website / Website de PFLAG Omaha
PFLAG National Website / Website de PFLAG National
Social Media / Medios Sociales
Family or Friend / Familia o Amigxs
Other:
Clear selection
Is there anything specific you would like to talk about or have the facilitator bring up during the meeting? - Algún tema en especial que le gustaría hablar o quien dirige la reunion lo haga
Your answer
Are you under the age of 18? - Es mayor de 18?
Yes / Si
No / No
Clear selection
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