Membership Application - Safe Zone

A project of the IUP Gay, Lesbian, Bisexual and Transgender Commission

About the Project

The Safe Zone Program establishes a visible network of university employees who wish to be supportive of persons who are gay, lesbian, bisexual, or transgender (GLBT). Recognizing that GLBT students and employees may feel isolated or frightened to identify their sexual orientation and/or gender identity, this project strives to develop a supportive campus environment. Members of the project display a symbol on their office door to identify them as a member. The University community will know this person is trained to provide information about University and community resources related to GLBT life. All university employees may apply to participate in the program. Persons who participate in the program agree to the following:

complete a Safe Zone orientation
display a Safe Zone symbol
serve as a resource to members of the University community who may wish to discuss GLBT issues
provide information about University and community GLBT resources
participate in training updates as needed
maintain privacy as described in the Safe Zone training manual

To Apply for Membership

Complete the application application below.

The Safe Zone Committee will review all applications and select project participants. Although all IUP graduate students are welcome to apply, priority will be given to those who work on an IUP campus. The Committee may interview applicants to obtain additional information.

*Required field

Give a brief history of your support and commitment to GLBT issues*

Explain your interest in becoming a member of the project*

Discuss any training about GLBT issues you may have received*

Your Name and Position

First Name*

Middle Name

Last Name*

Position*

Department Where You Are Employed*

Classification

Academic Department

Required only if you are a graduate student and your academic department is different than the department in which you work.

Contact Information

Your E-mail Address*

IUP Telephone Number*

IUP Mailing Address

Address Line 1*

Address Line 2

City*

State*

Zip Code/Postal Code*

I understand that as a member of the Safe Zone Project, I am openly declaring my support for GLBT issues and concerns. I agree to display the project symbol. I understand, as a member of the project, my name, work phone number, work address, and e-mail will be publicized. I agree to meet the responsibilities described above.