Alameda County Transgender Steering Committee

Alameda County Transgender Steering Committee

Membership

ACTSC Membership Application

Please fill out and mail form or fill out online form below.

Membership is also open to TG supporters; family members; or persons with other TG-related affiliations.

Fields are required.

Name:

Address:

City:

Zip Code:

Home Phone:

Cell Phone:

Work/Msg.:

Fax:

Your Email:

Please answer the following “confidential” questions:

Are you 18 years of age or older?:

Do you self-identify as Transgender?:

If so: Male-to-Female (MTF), Female-to-Male (FTM), Other?:

What is your Ethnicity/Race?:

Do you have specific health concerns/limitations?:

Are you able to commit to attending a meeting - once monthly:

Prefer to maintain "anonymous" membership status?:

Have you served on other community boards/task forces?:

If so, please list:

As a member of the Alameda County TransGender Steering Committee (ACTSC), I agree to abide by all rules and regulations as set forth by the Committee and, to conduct myself in a manner that is appropriate and reminiscent of the goals and objectives as previously adopted by the founding Committee members.

Signed (Type your name in this space):

Date:

I understand that my IP address will also be submitted along with my information.

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Alameda County Transgender Steering Committee

Membership

ACTSC Membership Application

Member Login How to support ACTSC

Upcoming Events

Categories

Newsletters

Purpose

Goal

Objective

Member Login

How to support ACTSC