2018 NJ Trans Youth Forum Group Registration
A Day for Transgender, Genderqueer, Gender non-binary, Genderfluid, and/or Gender Questioning Youth, Friends and Community Members!

Event Timing: April 21, 2018 9am-4pm
Event Address: New Brunswick High School, 1000 Somerset Street, New Brunswick, NJ 08901
Contact Information: lgbtq@hitops.org

Name of School or Organization *
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Full Name of Contact Person *
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Phone Number of Contact Person *
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E-mail Address of Contact Person *
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Address *
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Names of Adults
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GROUPS PLEASE NOTE: For safety purposes, an accurate list of all participants in the group you are registering who are actually present at the Forum must be provided at the registration desk when checking in on the day of the Forum)
Number of Students
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Please specify and give the number in your group who have dietary needs (Vegetarian, Vegan, Gluten Free):
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Please specify and give the number in your group who have accessibility needs (Mobility, Hearing, Other - please describe):
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The Forum registration fee is $20 per student and $50 per adult. No one is turned away because of inability to pay.
If you would like to request a reduced fee or waiver of fee, please indicate the number of people you are requesting for and the amount you can pay ($5, $10, or other amount)
I am requesting a reduced fee or waiver of fee. The number of students I am requesting for/the amount I can pay is:
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Media Release: **This permits photographs/videos to be taken of you and potentially utilized for marketing purposes http://tinyurl.com/gsa-mediarelease
Please indicate how you would like to pay. *
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