Come to GLSEN's 2005 Students of Color Organizers (SOCO) Retreat from January 14-17, 2005 in Minneapolis, MN. For more information, contact Marta at mcabrera@glsen.org or 212-727-0135 x152. Register below.

Note: The general deadline has passed however, in order to meet our goals for representation, applications are still being considered for Asian/Pacific Islander, Middle Eastern, and/or Native American students.

First Name:

Required

Last Name:

Required

Mailing Address:

Required

City:

Required

State:

Required

Zip Code:

Required

E-mail Address:

Required

Phone Number (+ Area Code):

Required

Cell Phone (+ Area Code):


Date of Birth (MM/DD/YY>

Required

HS Graduation Year:

Required

School Name:

Required

Club Name: If you are affiliated with a student club, commonly known as a gay-straight alliance (GSA) in your school, what is your student club's name?:


Group Affiliation: Choose what best describes the group you are affiliated with:
Support
Social
Advocacy
Activism


Gender Identity:


Sexual Orientation:


Race/Ethnicity (please note, this field is required since participation is for all students to identify as "people of color"):

Required

Why do you want to participate in the GLSEN 2005 Student of Color Organizers (SOCO) Retreat?

Required

Have you ever participated in a GSLEN or other safe schools organizing training in the past? If so, explain your role, what worked well and what would you have wanted to see done differently?


What leadership positions, either in your student club, safe schools organizing and/or people of color community groups, have you held?


Are you enrolled in a K-12 school for the 2003-2004 school year?
yes
no

Required

What do you think you could contribute to the GLSEN 2005 SOCO Retreat?

Required

Have you read and do you agree to the Requirements, Responsibilities and Roles?
Yes

Required