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Survivor Alliance Digital Town Square (DTS) Application Form

Need help filling out this form? Email membership@survivoralliance.org for assistance!

Thank you for your interest in joining the Digital Town Square (DTS)!

DTS is a moderated, survivor-centered online space created to foster community, collaboration, and shared learning across regions and lived experiences. This application helps us ensure that the platform is safe, accessible, and aligned with Survivor Alliance's values.

The questions below help us get you started on the app, keep the space safe and respectful, and ensure everyone can participate. They are not used to judge personal experiences or anyone’s value in the community. They are not used to evaluate personal experiences or determine anyone’s value to the community.

DTS is not a crisis intervention or emergency support platform. Please share only what you are comfortable sharing, and know that your responses will be reviewed confidentially.

Responses to applications may take up to 5-10 business days due to our small but mighty team! If you have any questions while your application is being reviewed, don't hesitate to reach out to membership@survivoralliance.org.
1.Full Name (as listed on your Survivor Alliance Membership)(Required.)
2.Preferred Name (if different)
3.Email Address (as listed on your Survivor Alliance Membership)(Required.)
4.Country(Required.)
5.If you have a Discord account already, what is your name?
6.Please select all that apply: How are you connected to Survivor Alliance?(Required.)
7.Why are you interested in joining the Digital Town Square (DTS)?
8.I have read and agree to follow the DTS Community Agreements [Click on the link to access](Required.)
9.If you read the agreements, what is our favorite part of the Survivor Alliance membership?(Required.)
10.How do you hope to use DTS?(Required.)
11.DTS is a community space designed for connection and shared learning. It is not a crisis or mental health support service, and it cannot provide immediate or ongoing mental health care. We want to be clear about this so expectations are supportive and respectful for everyone. Are you comfortable participating with this understanding?(Required.)
12.This community includes people with many different lived experiences, perspectives, and identities. Are you able to commit to engaging with others in a respectful and kind way, even when experiences or viewpoints differ from your own?(Required.)
13.If conflict or harm comes up and you are not able to resolve it on your own, are you willing to pause and ask moderators for support rather than escalating the situation?(Required.)
14.Do you have any accessibility needs we should be aware of that would help you participate comfortably in this space? Accessibility needs might include things like screen readers, captions, flexible timing, or other tools that help you engage fully.

Please let us know if you need specific accessibility features or applications for the Discord platform. We will do our best to add these supports whenever possible!(Required.)
15.Before you join DTS, is there anything you would like us to know or consider?
16.I understand that DTS is a shared community space and that access may be paused or removed if safety boundaries are broken.(Required.)
17.How did you hear about DTS?(Required.)
18.May we use feedback you share in DTS, without your name or personal details, to help improve the community?

This means that if you share suggestions, ideas, or feedback in DTS (for example, about features, guidelines, or how the space works), Survivor Alliance staff or moderators may use that feedback to make improvements. We will not connect your feedback to your name or personal information.(Required.)
19.Do you have any comments, concerns, or questions for staff? If so, drop below!