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SAFE ZONE CONTRACT AND CONFIDENTIALITY STATEMENT
MINNESOTA STATE UNIVERSITY MOORHEAD
MSUM Safe Zone seeks to from a network of students, faculty, and staff committed and trained to provide safe, non judgmental, and supportive contacts for all MSUM community members who may be dealing with lesbian, gay, bisexual, transgender and/or questioning issues. Responsibilities As a Safe Zone Contact Person at MSUM, I recognize my responsibilities to: promote an atmosphere
of confidentiality and inform the person coming into my office of
the limitations to that confidentiality not attempt to sway the person
to a different sexual orientation or viewpoint be a contact person and
positive listener to all who request my services as a Safe Zone Contact
Person provide reference materials and other resources about sexual identity
and support services for Gay, Lesbian, Bisexual, Transgender, and Questioning
people (GLBTQ) in the area provide support to any person who is dealing
with homophobia so she/he will not feel alone provide support and information
to people who are having difficulty understanding or dealing with the sexual
orientation of others (e.g., roommate, sibling, friend, etc.)
Rights
I recognize
that I have rights as a Safe Zone Contact Person. They are:
Signature
By signing this form I hereby formally declare my office/room to be a Safe Zone at MSUM, that I agree with my rights and responsibilities as a Safe Zone Contact Person, and that I agree to support each student, staff, or faculty person in her/his perceived sexual orientation and/or need for related support, information, or referral. Name (please print)
Office Address
Phone #
Department or Organization E-mail Address Signature Date |