Support Group Meeting

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Please complete this screening form to receive date/time/location of our next meeting. Thank you. ***If you are under the age of 18, form must be filled out by a parent or guardian. ***

Email *

How did you hear about us? *

PFLAG Acworth/Dallas

First and Last Name *

Pronouns *

Are you over 18? *

Yes

Would you like to receive our monthly newsletter and other important chapter information via email? *We promise not to spam!*

Yes

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Check all that you would like to be invited to join: *

Facebook Private Page- closed group invite only

Discord- Private Server- Invite Only

Required

Check all that you are hoping to attend *

In Person General Support Group 4th Sunday of Every Month

Trans Support Group *Virtual only for now* 2nd Thursday of Every Month

Required

By attending these meetings you agree to the following:

You will not disclose the location to anyone. *If there is someone that would like to attend with you, have them register separately.

You will not disclose the identities of anyone you see at meetings. Members may be at different stages of their journey and this helps respect their privacy.

You will help to create a safe and welcoming community where we can depend on each other for support.

Yes, I agree to all of the above.

We would love to hear from you! What would you like to see in this chapter? Choose all that apply or add a suggestion in the space provided.

Separate meetings for different groups (Trans Men/Women, Youth, etc.) Please specify what kind of group in "Other" section.

Virtual Support Group Meetings

Week night meetings

Other:

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