Safe Zone Program Application

Safe Zone Program Application

The Safe Zone Program establishes a visible network of university employees who wish to be supportive of persons who are lesbian, gay, bisexual, transgender/transsexual, queer/questioning, intersex, or allies/androgynous/asexual (LGBTQIA). Recognizing that LGBTQIA students and employees may feel isolated or too frightened to identify their sexual orientation and/or gender identity, or to express their gender in atypical ways, this program strives to develop a supportive campus environment. Members of the project display a symbol on their office door to identify themselves as a member. The University community will know this person is trained to provide information about University and community resources related to LGBTQIA life. All university employees may apply to participate in the program.

Persons who participate in the program agree to:

  • complete the Safe Zone training class
  • act at all times in ways that are supportive of the LGBTQIA community, as discussed in the training
  • prominently display the Safe Zone symbol  
  • serve as a resource to members of the University community who may wish to discuss LGBTQIA issues 
  • provide information about University and community LGBTQIA resources 
  • participate in training updates as needed 
  • maintain confidentiality as described in the Safe Zone training manual


To Apply for Membership

The Safe Zone Committee will review all applications and select program participants. The Committee may interview applicants to obtain additional information.

Safe Zone Program Application

Safe Zone Program Application

  • Name: Name:
  • Telephone Number: Telephone Number: - -
  • I understand that as a member of the Millersville University Safe Zone Program, I am openly declaring my support for LGBTQIA issues and concerns. I agree to display the Safe Zone symbol and to act as a supportive resource for LGBTQIA students and employees of the University. I understand that as a member of the program, my name, work phone number, work address, and work e-mail will be publicized. I agree to meet the responsibilities described above.

  • Draw or Type
    I understand this is a legal representation of my signature. Clear
  • Date Date / /
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