Registration deadline has passed
Custom RegistrationInvite only
Applicant Intake Form
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Deadline: Apr 20, 2024 12:00 am (GMT-05:00) Central Time (US & Canada)
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Date: Apr 20, 2024 10:00 am - Apr 20, 2024 2:00 pm (CDT)
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Free
About the event
About the registration
Terms & Conditions
Questions on the registration
User information
- First name
- Last name
Additional information
- Pick the situation that best describes you. Please read all options carefully before making a selection. (select one)
- Do you have an address where you can receive mail?
- Name
- Pronouns
- Pronouns (Other)
- Phone Number
- Alternative Contact Information
- Chosen First Name
- Chosen Middle Name (if none, leave blank)
- Chosen Last Name
- Have you ever used any other names (i.e., a maiden last name or married last name) and/or is your name on your birth certificate different than you current legal name?
- If yes, please provide any and all prior names below. Otherwise, type N/A.
- Sex Assigned At Birth (i.e., sex listed on your birth certificate at or around the time of your birth)
- Gender/Sex by Which You Identify
- I would like assistance in legally updating which of the following (select one):
- If updating gender, please select the gender/sex you would like listed on updated Identity Documents (Note: Texas Law requires selection of either Male of Female):
- Current Legal First Name
- Current Legal Middle Name (if none, write N/A)
- Current Legal Last Name
- Date of Birth (MM/DD/YYYY)
- Place of Birth: City
- Place of Birth: County (please include the word, "County")
- Place of Birth: U.S. State or Territory
- Place of Birth: State (Other)
- Place of Birth: Country
- Is your race listed on your birth certificate?
- If yes, what is your listed race? (If not applicable, enter N/A.)
- If "No" or "I don't know," please write the race you identify as (i.e., White, Black, Asian, American Indian/Alaskan Native, Hawaiian Native/Pacific Islander, Mixed). Hispanic is technically an ethnicity, not a race, so if you identify as Hispanic, select the race that you most closely identify with, as listed in the previous sentence. If not applicable, enter N/A.
- Home Address: Street (Number and Street Name)
- Home Address: City
- Home Address: County (Please include the word "County")
- Home Address: U.S. State or Territory
- Home Address: State (Other)
- Home Address: Zip Code
- Is your mailing address different from your home address?
- If "Yes," Mailing Address: Street (Number and Street Name)
- If "Yes," Mailing Address: City
- If "Yes," Mailing Address: U.S. State or Territory
- If "Yes," Mailing Address: State (Other)
- If "Yes," Mailing Address: Zip Code
- You will need to attach a short letter to your petition from a doctor or therapist/mental health counselor you see. Select one of the following:
- Upload a copy here (PDF, Word, PNG, JPG) and bring a printed copy with you to the clinic
- Last 3 digits of Social Security Number
- Driver's License or Identification Number or let us know you do not have this information
- Which state issued your driver's license or identification number?
- Which state issued your driver's license or identification number? (Other)
- Have you had any other driver's license numbers or identification numbers in the last 10 years?
- If "Yes," list each below (if not applicable, enter N/A)
- Have you ever been, or believe you may have been, charged with an offense above the grade of a class C misdemeanor (traffic tickets; charges punished by fine only)?
- Have you ever been, or believe you may have been, the subject of a final felony conviction?*
- Are you required to register as a sex offender?
- Please select your preferred time slot below
- Anything you need to tell us? Accessibility needs, etc.?
- By applying and signing this application electronically, I have read and agree to the Applicant Statement of Understanding. Type your Current Legal First and Current Legal Last Name

Applicant Intake Form
Name + Gender Marker Change Clinic (Dallas LGBT Bar Association in partnership with Pride Frisco)
Registration deadline has passed