I, __________________, hereby have permission to be imperfect with regards to people who are different from me. It's okay that I do not know all the answers about every human characteristic or issue or if, at times, my ignorance and misunderstandings become obvious. I have permission to ask questions that appear stupid. I have permission to struggle with these issues and be honest about my feelings.  I am, however, committed to educating myself, and others, about oppression, heterosexism, homophobia,
sexism, racism, etc. and to combating it on a personal
level.  I am committed to working toward providing a
safe, confidential support network for all diverse
human communities.  I am committed to treating everyone with the dignity and respect that they are entitled to as human beings. 
 

Signature: _____________________
Date:________________ 
 

The following information will be used for Allies membership and web listings. 
 
Please print clearly. 
 
 

Name: _____________________________ 

E-mail: ______________________________ 

Home Phone: _______________ 

Mailing Address:_________________________________ 

Student___ 

Anticipated Date of Graduation: _____ 

Faculty___ Grad Student___ Staff___ 

Do you have an office on campus? If yes, 

department: ___________ location: ____________ 

Work Phone: ______________  Mail Stop:

Check here if you do NOT wish to include your name & contact information in ALLIES newspaper ads.
 

_____ Check here if you do NOT wish to include your name & contact information on the ALLIES web site. 

_____Check here if you do NOT wish to join the ALLIES email listserv. 
 

Please be sure to update your information periodically  (especially if it changes each semester) through the our website.