ROAR Application Form
Group Description
Current Education
Are you currently in Middle or High School?
Please select...
Yes
No
Other
Thank you for your interest! Unfortunately, the R.O.A.R. internship is only available to individuals who are currently enrolled in a middle or high school. If you have any questions, please reach out to
Salem Joseph
at
sjoseph@gaycenter.org
.
Hidden Fields
Facilitator's Email
Group ID
Program Type
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1
2
3
4
5
6
7
8
9
Registration Status
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Active
Planned
Group Type?
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Closed
Special Event
Drop-in
Registration Status
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Open
Closed
Public Group Description
Thank you for your interest! Unfortunately, registration is closed due to being at capacity. Please keep an eye out for future groups and events on our website
www.gaycenter.org
Contact Details
First Name
Last Name
Age
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13
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31+
Birthdate
Primary Email
Primary Phone Number
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Thank you for your interest in this group. Unfortunately, due to age limits for our Youth Programming, this group is not available.
Please visit our
GROUPS PAGE
to explore our adult social groups.
Primary Address
Street Address
Apartment Number
City
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Zip Code
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Demographics
Pronouns
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He/him
She/her
They/them
No pronouns (just use my name)
Other
Pronouns (Self-Describe)
Gender
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Man (cis or trans)
Woman (cis or trans)
Non-binary
Genderqueer/Gender nonconforming
Prefer to self describe
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Gender (Self-Describe)
Transgender
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Yes
No
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Sex assigned at birth
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Intersex
Female
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Sexual Orientation
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Gay/Lesbian
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Prefer to Self Describe
Declined to answer
Prefer to Self Describe:
Race
American Indian, First Nations, or Indigenous
Asian (including East, Southeast, and South Asian)
Black, African-American, African Descent, or Afro-Caribbean
Hispanic or Latino/a/x
Middle Eastern
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More than one race
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Race (Self-Describe)
How did you hear about us?
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Counselor
Social media
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HRA
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Subway Ad
12 Step Program
Other
Other
Application Questions
What school do you currently attend?
What grade are you in?
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7th
8th
9th
10th
11th
12th
Other
If other, please explain.
Do you have any allergies?
Are you applying to be an
Intern
or
Youth Advisor (YA)
?
Youth advisors must have successfully completed a previous cycle of R.O.A.R.
Please select...
Intern
Youth Advisor
Please select
2
social justice issues you want to learn more about:
Cost of Living (Gentrification | Inflation/Wage Theft | The Housing Crisis)
LGBT Issues (Transgender Oppression | Rising Extremism | The Movement to Strike Down Same-Gender Marriage)
Gender Based Discrimination (Gender Pay Gaps | Sexism and Implicit Bias | Gender Based Violence | Body image)
Racism (The School to Prison Pipeline | Rising Extremism | Voter Suppression/Gerrymandering | Food Deserts/Health Disparities | ICE)
How would you define social justice?
What is a social justice issue you are passionate about?
Tell us about an experience where you used leadership skills.
Are you able to commit to coming on Wednesdays from 5:00 PM – 7:00 PM?
Yes
No
Are you able to commit to coming on Wednesdays from 4:30 PM – 7:15 PM?
Yes
No
This internship takes place at The Center, located at 208 West 13th Street, New York, NY 10011. Are you able to make it every Wednesday by 5:00 PM?
Yes
No
This internship takes place at The Center, located at 208 West 13th Street, New York, NY 10011. Are you able to make it every Wednesday by 4:30 PM?
Yes
No
This internship is through the LGBT Community Center. Our space is open to everyone, including allies, so you do not necessarily have to identify as LGBTQI+. However, you must be respectful to all pronouns, culture, and content. Is this something you can agree to?
Yes
No