Be a part of a movement that is ending anti-LGBT harassment and discrimination in all schools, apply today to the GLSEN Jump-Start Leadership Team below! (Please limit essay answers to 100 words.)

How accepting is your school? Please choose one of the four definitions that best describes your school's climate. If you need more detailed description, read this page before beginning the application.
Hostile
Resistant
Passive
Inclusive


First Name (Legal):

Required

Last Name:

Required

Preferred Name:


Can we use your preferred name when we call your house?
yes
no


Mailing Address:

Required

City:

Required

State:

Required

Zip Code:

Required

E-mail Address:

Required

HOME Phone Number (+Area Code):

Required

Cell Phone Number (+Area Code):


Date of Birth (mm/dd/yy):

Required

In what grade will you be during the 2008-2009 academic year?:

Required

School Name:

Required

Does your school have a Gay-Straight Alliance (GSA) or similar student club?
Yes
No
Not sure

Required

GSA or Club Name - If you are affiliated with a club in your school, what is your club's name?

Required

Is your GSA/Student Club registered with GLSEN at www.studentorganizing.org?
Yes
No

Required

Gender Identity:


Are you of trans experience?:
Yes
No


Sexual Orientation:


Race/Ethnicity:


Why do you want to participate in the Jump-Start leadership team (max 100 words)?

Required

What leadership positions, either in your GSA/other student clubs or other school and/or community groups have you held (max 100 words)?

Required

What experience and/or skills do you have in training, organizing and/or networking with other students (max 100 words)?

Required

Tell us about a time where you learned from a mistake. (max 100 words)

Required

Have you worked with a local GLSEN Chapter? If so, in what capacity? If not, have you worked with any other community organizations outside of your school? What have you done with them? (max 100 words)

Required

What else would you like to tell us about yourself (max 100 words)?

Required

Have you read and do you agree to the Goals, Responsibilities and Requirements?
Yes
No

Required

What does the term "safer schools" mean to you (max 100 words)?

Required

Are you 13 years of age or older?
Yes
No

Required

If you are younger than the age of 18, do you have your guardian's permission?
Yes
No

Required

Are there any concerns you may have about fulfilling this position (max 100 words)?


Are you going to be enrolled in a K-12 school for all of 2008-2009?
Yes
No

Required

Are you able to commit to a minimum of tem (10) hours a month to the Jump-Start team?
Yes
No

Required

Are you able to participate in two (2) conference calls per month and be on the call with your full attention?
Yes
No

Required

Are you able to finish monthly reports on your organizing activities?
Yes
No

Required

All finalists for the Jump-Start Leadership Team will be interviewed over the phone. Will this be an issue for you?
Yes
No

Required

Will you be able to attend a Jump-Start training during July 9-14, 2008?
Yes
No

Required

Before every training a GLSEN staff member will phone you and your parent/guardian to review ground rules and answer any questions they may have about the training. Will this be a problem for you?
Yes
No

Required

How often do you have access to the Internet? To the telephone?


By what date do you expect to send us your Recommendation Form?


Do you have any additional comments (max 100 words)?


We encourage all students who have the opportunity, to get involved with local GLSEN Chapters or other out-of-school organizations to support the work they are doing to make schools safer. If you do not get selected to be on GLSEN’s 2008-2009 Jump-Start National Student Leadership Team, would you like us to help get you connected with a local Chapter? By selecting "yes," you are agreeing to have us pass your contact information on to the leader of a GLSEN Chapter.
Yes
No


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