Student Intake Form
There are many amazing student activists in Texas who want to participate in school safety walkouts and gun violence protests. There are also many attorneys and advocates who want to provide resources, advice, and other assistance to students whose schools/school districts punish or threaten to punish them for protesting.

Please complete and submit this form if:

1. you are a student or you know a student who has been punished for participating in a school safety protest OR

2. you are a student, parent, or educator at a school or school district that is threatening to punish students who participate in school safety protests.

After your form is submitted, you will receive a call or email from someone who can answer your questions about your rights during protests and how your school may address student protestors.

For immediate answers, please check out the information and resources at --- they may be helpful to share with your school or school district administrators. They may also help you and other students understand your rights and what you should expect from your school.

What is your first name?
Your answer
What is the best way for us to get in touch with you? (please include your phone number, email address, etc.)
Your answer
Are you a . . .
What is the name of your school?
Your answer
What is the name of your school district or charter school network?
Your answer
What is your zip code? (This will help us to figure out if there is someone in your community who could help you.)
Your answer
Please check the box or boxes that best describe what happened in your school or district:
Please explain what happened. (Please include when the incident happened, details about what happened, and links to official responses from your school, if any.)
Your answer
How would you like for us to help you?
Your answer
If you are able, please paste a link to your school's Student Code of Conduct
Your answer
Is there anything else you'd like for us to know?
Your answer
Never submit passwords through Google Forms.
This form was created inside of Texas Appleseed. Report Abuse - Terms of Service - Additional Terms