QUEERSPACE hangouts Mentor Application

Welcome

Thank you for your interest in supporting our amazing LGBTQ+ youth community.

To apply to be a QUEERSPACE hangouts mentor, please complete the following information requested below. The application will take approximately 15-20 minutes to complete.

We are seeking mentors with a wide variety of personal and professional backgrounds. We strongly encourage black, indigenous and people of color (BIPOC) and transgender and gender non-conforming people to apply.

If you have questions about this application or becoming a mentor, please send an inquiry to info@queerspacecollective.org.

Are you applying for the Twin Cities Metropolitan Area or the Saint Cloud Area? *This question is required.

GENERAL INFORMATION
Information will not be shared outside of QUEERSPACE collective.

First Name *This question is required.

Last Name *This question is required.

Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Pronouns
Check all that apply *This question is required.

He/Him/His
She/Her/Hers
They/Them/Theirs
Other

If you said other, please specify,

Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Primary Phone Number *This question is required. Please provide a 10-digit phone number including area code.
Enter numbers only. Formatting such as dashes will be added as you enter your phone number.

Secondary Phone Number

If you said other, please specify. *This question is required.

Emergency Contact Information *This question is required.

First and Last Name

Phone Number

Relationship to applicant