Queer, Trans & Allied Student Summit — Fall 2019
Everyone who attends the Summit must complete this registration form either online or in person the morning of the Summit. If you have any questions, contact us at (831) 427-4004 or info@QYTF.org or visit the Summit website.

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Email *
Phone Number *
Registration
As it will appear on your name tag (Name, Pronouns, School/Student Club or Organization).
First Name *
Last Name *
Gender Pronouns *
School, Student Club or Organization *
Pick a lanyard for the day of the event!
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First 150 students to regsister get an enamel pin
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The following questions are for our information only and will not affect your ability to attend the conference.
Race or Ethnicity *
Required
Genders *
Required
Sexualities *
Required
What year are you in school now? *
Required
What city are you from? *
Required
How are you arriving to the summit? *
Required
Food & Accommodations
I need the following type of food accommodations *
Required
Allergies *
Required
Additional Accommodations *
Required
Emergency
Name of Emergency Contact *
Emergency Contact Phone Number *
Where did you hear about the Spring 2019 Queer, Trans & Allied Student Summit?
*
Required
What topics would you like to see as workshops at student summits like this one?
Check all that apply
*
Required
What do you wish to get out of the summit?
Check all that apply
*
Required
What do you want to do with what you will learn from this summit?
Check all that apply
*
Required
Should we be discreet when contacting you?
*
Required
Community Service Hours
Students who attend the Queer, Trans, and Ally Student Summit may be able to earn school credit for participating in the summit. If your school has a community service, volunteer, or similar requirement, talk to your school counselor to see if you can earn credit for attending the summit. Be sure to bring any required paperwork or forms to be signed by Summit staff.
I’d like to start receiving the “Queer Youth Updates” electronic newsletter that includes local and regional LGBTIQ/Ally events, news, resources, scholarship information and more.
*
Required
Thank you for registering for the Queer, Trans & Allied Student Summit - See you soon!
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