University of Georgia Safe Space

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Individual Registration Form

Name:

E-mail Address:

Phone Number:

Office/Department:

Campus Address:

Please select one of the following which best describes your connection with the University of Georgia:

Which session would you like to attend?

Read before submitting form:

By signing up for this session, I understand that Safe Space is a voluntary program and is not intended to be used as a required training program by my department, my supervisor, or the university.

By participating in the program, I pledge to:

Strive toward continued development, learning, awareness, and action, and to search for further ways of understanding LGBT individuals
Promote an environment where members of the LGBT community do not have to censor their identities
Promote an atmosphere where members of the LGBT community can participate fully, equally, and openly in campus life without fear of discrimination and/or harassment
Promote a safe and affirming place for LGBT people by offering an atmosphere and personal relationship of respect, fairness, and trust
Serve as a resource of information for students, faculty, and staff having questions about LGBT issues, and be willing to refer students to support and resources on campus and in the community
Maintain confidentiality