2014 OUTLIST Registration
Thank you for your interest in being an OUT and proud member of the LGBTQ and Ally community! UCLA is consistently named one of the top LGBTQ-friendly campuses in the nation because of people like YOU, who are willing to be out and open about your commitment to nurturing a safe and healthy community for all gender and sexual identities. Your choice to be visibly out paves the road for others to come out and lets LGBTQ students, staff and faculty know that we are all supported and valued as a part of the campus community.

The information below will be publicized in the annual OUTLIST, the listing of LGBTQ and Ally community members, which will be published in the Daily Bruin on October 10, 2014 as a part of National Coming Out Week. Please note that due to space restrictions, your entry may be edited for length.
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The deadline to submit your registration is October 3rd, 2014.
Name *
As you would like it to appear in the listing. Please note that we do not accept names of departments, units or groups, you must name a specific person in order to be published in the OUTLIST.
UCLA Affiliation *
You can list your title & department, major, leadership position, student organization, or any other indicator of your status in the UCLA community.  Example: Intern, LGBT Center
Email Address *
So we can contact you about next year's OUTLIST, will NOT be published
UCLA Affiliation Category *
For our data collection purposes only
Title or Quote (optional)
Limit: 50 characters. Example: Queer advocate and snowboarding enthusiast
Would you like the information above to be posted on the LGBT CRC's website? *
This information will be publicized at www.lgbt.ucla.edu 
If yes (to the above question), is there an organizational website you would like us to link your entry to? Ex: your student org website, your departmental website, your professional webpage, etc.
Please enter the complete web address.  Ex: www.lgbt.ucla.edu
Have you participated in one of our LGBTQ Ally trainings? *
How did you hear about the OUTLIST? *
Please check all that apply
Required
Will you help us raise visibility by forwarding this form to other LGBTQ and Ally members of the UCLA community?
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