Pen Pal Program Interest Survey 2023-24
Thank you for joining Gay City: Seattle's LGBTQ+ Center's queer and trans pen pal program!

Our goal is to connect queer and trans young people ages 12-24 across the state of Washington. We work with schools and community organizations in order to protect each pen pal's privacy and confidentiality - your school or community organization will send and receive sealed letters on your behalf to keep your address private.

THIS PROGRAM IS ONLY ACTIVE DURING THE SCHOOL YEAR. During the summer break please apply to our discord server to stay connected with other LGBTQ+ youth.

To better match you with a pen pal, please complete this interest form.

If you are Seattle based, let us know below if you'd like for us to collect mail for you at our LGBTQ+ Center: 400 E Pine St Suite 100, Seattle, WA 98122
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Email *
What is your first name?
Use the name you wish us to honor.
 *
What is your last name?
Use the name you wish us to honor. *
What are your pronouns? (Example: She/Her, They/Them, He/Him, Ze/Zheir, Any Pronouns, My Name, It) *
Your year of birth *
What is your zip code? *
What best describes your race? 
Check all that apply
What is your ethnicity?
Clear selection
What is your current gender identity? Check all that apply
What is your attraction orientation?  Check all that apply
Do you have a disability?
Seattle's LGBTQ+ Center does not solely rely on the legal definition of disability, which recognizes a disability to be a physical or mental impairment that impacts one or more major life activities. We recognize that society disables individuals, whether or not their disability is recognized, by maintaining discriminatory practices that oppress people who are not able-bodied. For the purpose of this question, disabilities may include mental illnesses, chronic illnesses, developmental disabilities, temporary disabilities, and anything else an applicant may consider a disability. This information is requested for Seattle's LGBTQ+ Centers reporting purposes and will not be shared in connection to any personal identifying information. To learn more about how Seattle's LGBTQ+ Center understands disability, please refer to the following links: (1) What is Disability by the Disability & Philanthropy Forum: https://disabilityphilanthropy.org/resource/what-is-disability/ (2) What is Disability Justice by Sins Invalid https://www.sinsinvalid.org/news-1/2020/6/16/what-is-disability-justice.
Clear selection
Have you or are you currently experiencing housing insecurity or homelessness?
Clear selection
Have you experienced domestic violence?
Clear selection
What school or community organization are you attending? *
School address or community organization where you can receive letters (NOT HOME ADDRESS)
 *
REQUIRED: Who is the educator or staff member that will receive your mail at the school/community organization?  *
REQUIRED: Email of the above educator or staff member *
Does your school have a GSA or similar group of LGBTQ+ people?
Clear selection
Tell us something you love about yourself. (e.g. I have great taste in music, I’m good at drawing monsters)
What are some of your passions, skills, and goals?
Is there anything else about you that you want us to share with your future pen pal?
What else can we learn about you to support you in this program? Any access needs?
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