GPS request

Please answer a few short questions so that we may match you with the best possible GPS team member. This form is confidential.

Your Name:

Age:

Year in School:

School/College:

Major/Minor:

Email:

Contact Phone:

How comfortable are you with your sexual orientation at this time?

How sure are you of your sexual orientation at this time?

If you are sure, what is your sexual orientation?

How comfortable are you with your gender identity at this time?

How sure are you of your gender identity at this time?

If you are sure, what is your gender identity?

What is your racial identity?

What is your ethnic background?

What is your religious background?

What is your current religious affiliation/identity?

How important is your religion to you?

Identities:

Please list any other identities which are significant for you.

Interests and Involvement:

Please tell us about your interests, including any clubs or student groups of which you are a member.

Interest:

Why are you interested in meeting with a GPS team member?

Questions and Topics:

What questions or topics have been on your mind that you would like to discuss?

Program:

How did you hear about our program?

GPS Team Member:

Do you have any preferences (race, ethnicity, gender, etc.) in your GPS team member that you would like us to consider when pairing you?

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