FLUX Member Profile

FLUX Member Application & Profile
FLUX AIMS TO RAISE THE PROFILE OF THE TRANS* AND NON-BINARY COMMUNITY BY LEVERAGING SOCIAL EVENTS, CREATING SAFE SPACES, AND INNOVATIVE ADVOCACY INITIATIVES.
Are you Trans or Non-Binary Identified?*
Name*

First NameLast Name
Pronouns*
Best Contact Number*

Area CodePhone Number
Emergency Contact Number*

Area CodePhone Number
Name of Emergency Contact

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
FLUX Chapter*
Are you applying for a board position? If so; which one?
E-mail*
Social Media Instagram
Social Media Facebook
Social Media Twitter
Social Media Snapchat
Profile Photo*

Browse Files

Cancelof
Upload your bio*

Browse Files

Cancelof
Upload your resume*

Browse Files

Cancelof
Some FLUX members have a presence with organizations. Please let us know about your affiliations & your role with each of them.
Affiliated Organization(s)
How did you hear about FLUX?*
Why do you want to be a member of FLUX?*
Have you attended a FLUX event before? If so, which event and tell us about your experience?*
What specific skills can you utilize for FLUX?*
Signature

Clear
Should be Empty:

FLUX Member Application & Profile