Coastline College Dolphin Pride Scholars Registration Form

Submit this form to join Coastline College’s Dolphin Pride Scholars (DPS) Program and access programs, resources, and information. You may complete this form at any time. All Coastline College students are eligible.

For program benefits, visit coastline.edu/lgbtq-plus or follow us on Instagram @dolphinpridescholars.

First Name

Preferred/Affirmed Name

Last Name

Pronouns

If you selected other, please specify what pronouns you use

Birthdate

Phone Number:

Personal Email Address

Select one that applies for you

Student

Staff/Faculty

Community Member

Student ID

Student Email Address

What year do you intend to start at Coastline?

What are your current academic goals? (select all that apply)

Are you interested in using DPS services?

Yes

No

Which services are you interested in learning more about?

Weekly/Bi-weekly check-ins (structured support, goal tracking, progress updates)

One-on-one mentoring (flexible guidance for academics, career, or personal goals)

Group Talks (peer-led discussions on LGBTQ+ topics, identity, and wellness)

Monthly LGBTQ+ Celebrations & Awareness Events (Queer Prom, Lavender Celebration)

Educational Workshops (LGBTQ+ terminology, pronouns, know your rights, etc.)

Leadership Opportunities (Pride Club, camps, conferences, summits)

Student Employment / Volunteer Opportunities (gain experience and support campus programs)

Sexual Health & Wellness Resources and Referrals (Access to sexual health supplies and referrals to campus and community resources)

DPS is also here to help get you connected to resources on campus to help you succeed. What are you interested in learning more about?

Yes

No

Which community programs are you interested in learning more about? (select all that apply)

Basic needs support (housing, food, Dolphin Pantry, CalFresh)

Finding community on campus (clubs, student organizations, peer groups)

Financial support (grants, scholarships, FAFSA, CADAA)

Academic support (tutoring, workshops, academic counseling)

Professional development (career advising, internships, job prep)

Health and wellness support (mental health services, health services, Title IX)

Transfer and degree planning (CSU/UC/private/university guidance)

Equity & identity-based programs (Lotus, Umoja, Dream Resource Program, DSPS, EOPS, NextUp, Guardian Scholars, CARE, CalWORKs)

Not sure / I’d like help figuring out what’s right for me

Employee ID

Employee Email

Please select one that applies for you:

Staff

Faculty

Which services/opportunities are you interested in learning about?

Would you like to include communications from Dolphin Pride Scholars?

Yes

No

Which communications would you want us to use? (select all that apply)

Email

Text

Coastline College Dolphin Pride Scholars Registration Form

SIGN UP FOR DOLPHIN PRIDE SCHOLARS HERE!