P-SAP Application

First Name *

Last Name *

Affirmed Name

Affirmed Name can be a nickname, preferred name, or any title you wish to go by.

What are your pronouns?

Phone Number *

Email *

Discord Username

If you don't have an account, please make one! Discord is where we communicate the most

Best Contact Method *

Discord Direct Message

Phone Call

Text

Email

Birthday *

P-SAP is only available to students who are between the ages of 14-24

School District *

School *

Grade *

Club/Organization Name *

Which of the following describe you? (Select all that apply) *

I hold a leadership position in my school's GSA/other LGBTQ+ group on campus

I intend to start a GSA/other LGBTQ+ group on campus within the next school year

I have been designated by someone with a leadership position mentioned above to represent my school's GSA/other LGBTQ+ group in P-SAP

Staff Sponsor First Name *

Staff Sponsor Last Name *

Staff Sponsor Email Address *

Staff Sponsor Phone Number

What days are you most available to participate in P-SAP? *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

What do you hope to get out of P-SAP? *

Grow my LGBTQ+ org

Learn more about LGBTQ+ issues

Meet other like-minded people

Get ideas for activities/events to hold at my GSA

Gain access to resources for my LGBT club/org

Learn more about community service opportunities

Learn more about the resources PRISM provides

How do you describe yourself?

Currently, do you consider yourself to be:

Do you identify as transgender?

Yes

No

Prefer not to answer

I identify myself as:

Asian

Black/African

Hispanic/Latinx

Native American

Pacific Islander

Mixed Race

White

Other

Tell us about yourself and why you're applying

No pressure and no wrong answers ! :)

Data Privacy & Consent

Yes, I would like to receive text messages from PRISM sharing stories of our impact, campaign progress, and opportunities to give.