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LGBTQ Caucus Membership Form FY 2024-2025
Please fill out the below form.
Individuals qualify for membership if they are current social work educators, educational administrators, or students interested in careers as social work educators.
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* Indicates required question
LGBTQ Caucus Member Status
New Member (No previous paid membership)
Continuing Member (Renewing existing paid membership)
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Last Name, First Name
Your answer
Email Address
*
Your answer
Institutional Affiliation
Your answer
What is your role?
Faculty
Administrator
Student
Post doctoral fellow
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If faculty or administrator, what is your job title?
Your answer
If student, what is your current degree program?
Your answer
If you contributed to the Q Caucus (on PayPal:
https://www.paypal.me/qcaucus
) in an amount exceeding your membership fee, how would you like your donation to be directed? Student membership is $10/year, and staff/faculty membership is $25/year.
General Fund
Specified Member/s or Student/s Membership Fee
Unspecified Member/s or Student/s Membership Fee
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If your payment is to be directed to another person, please specify their name.
Your answer
Thank you! If you have questions about your membership, please email
info@qcaucus.com
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