Name *

First Name

Last Name

Phone Number of Primary Contact *

(###)

###

####

Describe the primary reasons for contacting the Illinois Safe Schools Alliance (you may select as many as are applicable) *

Alternatives to punitive practices for classroom management and responding to violence

We are working on our school climate and culture and we want to examine how to create affirming environments for our LGBTQ+ students.

We want to provide our school staff with a common language and understanding of gender and/or sexuality and healthy identity development.

A transgender or gender expansive young person attends our school and we are seeking support for understanding best practice.

Students at our school have asked for staff training around best practices for supporting LGBTQ+ students.

Teachers at our school are reporting more and more students coming out as gender expansive and/or LGBTQ+ and have requested professional learning about serving LGBTQ+ students.

Parents in our community are requesting school staff receive professional development about serving gender expansive and/or LGBTQ+ youth.

New policies about gender have been developed and we want to learn how to most effectively implement them.

Our school has been engaged in equity work and we would like to establish ourselves as a leader by drafting and implementing inclusive policies and/or AP’s.

Our school is experiencing negative pressure from some parts of our community about our inclusive practices and we need support for responding sensitively and respectfully.

Our school is interested in starting GSA (Genders and Sexualities Alliances) and we would like your support.

Our GSA is looking for ideas for programming.

We have a specific question that is related to an urgent situation at our site.

General Consultation (please answer the question below)

Other (please answer the question below)

Do you have a budget for these services? *

Yes

No

Do you have particular dates you are seeking for workshops? *

Yes

No, we have flexibility

Has your school or district worked with the Illinois Safe Schools Alliance in the past? *

Yes

No

Does your school have a Genders and Sexualities Alliance, Gay Straight Alliance, or similar LGBTQ+ student group?

Yes

No

Is the GSA advisor linked to the Illinois Safe Schools Alliance "Advisor Listserv"?

Yes

No

No, but they would like to be

Has your school assessed curriculum for LGBTQ+ inclusivity?

Yes

No

Has your school ever completed a climate and culture survey that assesses the needs of LGBTQ+ students and staff?

Yes

No

Does your school train staff annually on best practices for supporting LGBTQ+ students

Yes

No

Has your school ever engaged in a longer study (year long or multi-year) on creating affirming environments for LGBTQ+ students and staff

Yes

No

Does your District have clear policies or procedures for transgender student inclusion?

Yes

No