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WYPT '25 Symposium Registration Form

Welcome to the registration form for the WELL.YES LGBT+ Youth Symposium: Stigma to Strength on June 28, 2025 at The Rotunda 4014 Walnut Street Philadelphia, PA 19104.

  • The Symposium indoor activities are geared towards black and brown LGBT+ students ages 13-24; outdoor activities are open to the public
  • Questions with an asterisk (*) are the ONLY required questions
  • If you're interested in volunteering, click the link in the thank you message at the end.

Need support? Email Mx. Trinitee Wilson at trwilson@phmc.org or text/call 267.559.7104.

Let’s build something powerful—together.

2. Do you have a chosen name? *This question is required.
4. Preferred Pronouns *This question is required.
8. What is your race and ethnicity? Please select all that apply. *This question is required.
9. What is your gender identity? *This question is required.
10. Do you Identify as transgender? *This question is required.
11. What describes your sexual orientation?  Select all that apply. *This question is required.
  • * This question is required.
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