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Welcome Here Decal Application

By completing this form, you pledge on behalf of your organization/ company to:

  • Commit to creating a safe space for LGBTQIA+ people.

  • Place the Welcome Here decal ideally near the building's front/public entrance.

  • Respect the names and pronouns people share.

  • Provide services without discrimination based on sexual orientation, gender identity, or gender expression.

  • Seek to prevent harassment or discrimination within its space.

  • Hold myself and employees accountable for our collective responsibility to allow LGBTQIA+ people to feel Welcome Here.

​"We pledge to welcome and respect LGBTQIA people, honor the names and pronouns they share, provide services without discrimination, and continue working toward a space where everyone can feel seen, valued, and safe."

For internal JLA correspondence only.

For internal JLA correspondence only.

Organization Information

How does your organization or business operate?

Check all that apply.

How would you like to receive your Welcome Here materials?
Digital badge
Physical decal
Both

Leave blank if you request a digital badge only.

Would you like your organization or business included in the public Welcome Here directory?
Yes
Yes, but please contact me before publishing
No, I’d prefer not to be publicly listed
How would you describe your business, organization, or space?
Out & About: Shops, salons, restaurants, cafés, bars, bakeries, and other local businesses and services.
Allied Care: Therapists, counselors, healthcare providers, and wellness services.
Open Expression: Arts organizations, galleries, theaters, music venues, and cultural spaces.
Good Together: Nonprofits, advocacy organizations, social groups, and community organizations.
Open Faith: Places of worship, faith communities, and spiritual organizations.
Other

Please choose the closest match.

Restrooms

What types of restrooms are available at this location?

Check all that apply.

Do the single-user restrooms lock from the inside?
Yes
No
Not applicable
Are changing tables available?

Check all that apply.

Optional Questions

(Please note: Training classes are not a requirement to receive the Welcome Here Decal or Badge)

Are you interested in possible participation in a photo opportunity with a featured JLA member?
Yes
No

(Please note: Participation in a photo opportunity is not a requirement to receive the Welcome Here Decal or Badge)

Would you like any of the following identities highlighted in the directory?

If applicable, check those you’d like publicly displayed.

PNG with a transparent background preferred.

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JAX Leaders & Allies - 3967 Brampton Island Ct. S., Jacksonville, FL 32224
JAX Leaders & Allies is a 501(c)(3) nonprofit organization. EIN: 33-3569925. Florida Registration No. CH80020.​

​

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES, DIVISION OF CONSUMER SERVICES, BY CALLING TOLL-FREE WITHIN THE STATE AT 1-800-HELP-FLA (435-7352) OR VISITING FDACS.GOV/CONSUMERSERVICES. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

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