Facility Use Application

Facility Use Application
Your Contact Information
Your Name*

First NameLast NamePronouns
Your Email*
example@example.com
Your Phone Number*
Your Preferred Method of Contact*
Your Preferred Method of Contact*

EmailPhone CallTextAny of the above
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

501c3 Non Profit
Are you a 501c3 Non-Profit?*

YesNo
Upload 501c3 Documents*

Cancelof

Social/Support Groups
Group Proposal Guidelines

Affirmations encourages community members to create new and engaging groups in service of the LGBTQIA2S+ community. This guide is designed to support the proposal process and ensure any new or existing groups are servicing the community equitably and effectively. All new group proposals must be submitted to Program Staff. Groups are created and/or disbanded at the discretion of Affirmations’ Program Staff.

Affirmations hosts four types of groups:

Support: Social/emotional support, discussion of oppression, relational difficulty, and trauma.

Discussion: Sharing of general information and discussion of voted/selected topics.

Activity: Specific gathering to do a task, such as writing, drawing, movie viewing, card games, etc.

Social: Space that is specific to getting to know one another and building community.

Eligibility

To be eligible, facilitators of support and discussion groups with Affirmations must abide by all General Volunteer Program requirements, guidelines, and background checks. Facilitators must also participate in Affirmations’ Facilitator Training and sign the Group Facilitator Agreement.

The Group Facilitator Agreement, requires facilitators to agree to:
- Teach and model cultural & behavioral sensitivity and awareness.
- Create, plan, advertise and implement an established group schedule.
- Model group rules, manage minor violations, and guide meetings.
- Communicate effectively with Center Guests and Affirmations’ Staff.
- Report to Program Staff suspected and/or potential violence, criminal activity, and self harm.
- Refrain from presenting personal political views while representing Affirmations.
- Be professional by not discussing Affirmations’ confidential business in public spaces and via social media.
Mandated Reporting:

All facilitators must report to Staff suspected and/or potential violence, criminal activity, and self harm. Confidentiality does not exist where there is threat to safety and to life. Lack of compliance to Mandated Reporting will result in dismissal. Reinstatement will be determined by Staff Quorum.

Affirmations groups have access to shared community resources like virtual meeting platforms, marketing support, facilitator training, optional group mediation/de-escalation by Aff staff, as well as staff taking care of community inquiries about your group.

Groups seeking space have access physical space at Affirmations and will be connected to our Operations department to discuss space agreements. You are not seeking marketing support and do not need or want to use Affirmations website and resources for advertising.
If you interested in this existing group becoming an Affirmations group or are you seeking space to use for your group? (refer to the explanations above)

Affirmations GroupGroup Seeking SpaceI'm not sure which one I fall under
Outside Organization(s)
Do you or your group have a governing body or organization that you would report to?

YesNo
What organization or governing body do you report to?
Is this a group that already exists outside of Affirmations with regular meetings and attendees?

YesNo
Is this a therapy group led by a licensed counselor or therapist?

YesNo

Proposed New Social/Support Group
Proposed Group Name
What type of group is this?

Support: Social/emotional support, discussion of oppression, relational difficulty, and trauma.Discussion: Sharing of general information and discussion of voted/selected topics.Activity: Specific gathering to do a task, such as writing, drawing, movie viewing, card games, etc.Social: Space that is specific to getting to know one another and building community.
In a few sentences, please describe the purpose of this group. What community needs would this group fulfill?
Facilitation
Who would be facilitating the group? Please list the name and email addresses of any and all proposed facilitators.
In the following question please describe individual experience and/or training that qualifies the proposed facilitator(s) to facilitate the group. This information should include any personal or professional experience that connects back to the purpose of the group. Strong preference is given to facilitators who identify as a member of the LGBTQIA2S+ community.

Please also address the proposed facilitator(s) experience in facilitation. While all new facilitators will receive training from Affirmations Program Staff, proposed facilitator(s) are expected to have experience that would support their success in running a group. This could include, but not be limited to experience in: small group facilitation, public speaking, running meetings, creating meeting agendas, leadership, and active interest in personal and professional development. Therapeutic support groups should be facilitated by a skilled facilitator (ideally a licensed professional); Health and/or nutrition focused groups should be co-facilitated by a health/wellness professional; Harm reduction groups should be facilitated by someone with training and ideally lived experience related to the subject matter).
What directly applicable experience do you or your proposed facilitator(s) have to run this group?

Event Information
Facility Date(s) Desired *
Start Time*
End Time*
Number of people expecting to attend*

0-1516-3031-6060+
Please describe your event in as much detail as possible *

Is there anything else you would like us to know?
Should be Empty:

Facility Use Application

Your Contact Information

501c3 Non Profit

Social/Support Groups

Outside Organization(s)

Proposed New Social/Support Group

Facilitation

Logistics

In order for this proposal to be considered, we will need 5 messages of support from community members who would be interested in joining this group. Please share the link below with them.

Event Information