DCAC Educational Development Registration 2024-2025

SCHOOL INFORMATION
What school do you attend?*
Grade level for the 2023-2024 school year*
Grade level for the 2024-2025 school year*
What is your strongest academic subject?
What is your weakest academic subject?
What are your extracurricular activities for the 2024-2025 school year?*
List any honors and awards (including Honors/AP classes for high school students)
What is your career goal?*

ABOUT YOU
List all non-school related organizations and clubs to which you belong:*
List the community service projects in which you participate during the school year:*
What are your hobbies?*
List your special talents and skills:*
What, if anything, would prevent you from fully participating in the Delta Academy or Delta GEMS Saturday sessions?*
How did you hear about the Delta Academy/GEMS program?*

Social MediaA friendA DeltaYour school counselor or teacherOther

PARENT/GUARDIAN INFORMATION
Mother/Guardian's Name*

First NameLast Name
Mother/Guardian's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother/Guardian's Phone Number*

Area CodePhone Number
Mother/Guardian's Email*
example@example.com
Father /Guardian's Name

First NameLast Name
Father/Guardian's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father/Guardian's phone number

Area CodePhone Number
Father/Guardian's Email Address
example@example.com
Please attach a copy of your most recent report card as proof of a minimum 2.0 cumulative G.P.A.

Browse Files

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Please make sure that we have accurate email addressess as we will send the orientation meeting for parents and GEMS via email. If you have any questions and/or comments, please contact us via email at dcac.gems@gmail.com
Applicant Signature*

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