Thank you for your interest in becoming a member of the Sexual Orientation and Gender Identity Youth Advocacy Council (SOGI YAC). Please fill out the membership form below and submit your application to the board for review.

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* First Name

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* Last Name

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* Preferred Pronouns

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* Contact Information

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* Primary Daytime Phone Number

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* Number to Receive Texts

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* Primary Email

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* Secondary Email

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* Employer

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* Job Title

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* Reason interested in being a member of SOGI YAC.

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* Do you have any legal sanctions prohibiting you from contact with minor children (such as being listed on a Sex Offender Registry)? 

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