Register Your GSA

Fields marked with an asterisk (*) are required.

Your email address:*

Name of your school:*

City:*

State:*

Name of your club:*



Student Details

Student leader’s first and last name:*

Student’s graduation year:*

Student’s email:*

Student’s phone number:

Student’s address, city, state and zip code:


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Advisor Details

Advisor’s name (you can enter more than one):*

Advisor’s email:*

Advisor’s phone number at school (including area code):*

Advisor’s phone number at home (including area code):



General Details

Tell us about how and when your GSA got started:*

Tell us how GSAFE can help your GSA:*

Any other comments:*

I would like to have my GSA published in the Wisconsin GSA Directory, which will go on the GSAFE website:	Yes No


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You can also print and mail this registration form to:

GSAFE
122 E. Olin Ave. Ste. 290
Madison, WI 53713

Fax your registration form to:
(608) 661-1360

If you have questions, please call us at 608-661-4141.

Testimonials

“Chippewa Falls Middle School’s mission is to provide a safe and supportive place for all of our students to learn and grow together. The Safe Space training from GSAFE provided staff with valuable resources to become more aware of how to be a better gender inclusive school!” – Susan Kern, Middle School Principal