Register your GSA

GSA

School

GSA Club Name

Street Address

City

Postal Code

State/Province

Country

Is this a community-based GSA?

Yes

If your GSA is a community based GSA, please enter the name of the person who will be most responsive to emails sent to your GSA in the student section and leave the advisor section blank - except for address- unless there is a designated advisor or mentor for your club. If your club is a school based club, please check "no" and proceed as indicated.

Tell us about how and when your GSA got started

Tell us how GSA Network can help your GSA

Any other comments

Advisor

First Name

Last Name

Job Title

Be Discreet?

Yes

Street Address

City

Postal Code

State/Province

Country

Work Phone

Home Phone

Cell Phone

Secondary Email

Student

First Name

Last Name

High School Graduation Year

Be Discreet?

Yes

Street Address

City

Postal Code

State/Province

Country

Phone Number

Cell Phone

Register your GSA

GSA

Advisor

Student

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