Reference letters may not be written by the applicant, his relatives, legal guardian(s), or anyone under the age of 21. Members of Delta Sigma Theta may provide a letter of reference IF the letter is written in her official capacity (i.e. the Delta is the applicant's teacher, employer, etc).

The applicant must advise the reference provider which CRITERION he wants the provider to validate: (1) School Involvement & Leadership Experience, (2) Academic Achievements, or (3) Volunteer/Community Service or Work.

CRITERION

1. School Involvement & Leadership Experience: Describe the student's ability to guide, inspire, direct or set examples for others and give examples of their leadership in their personal, community or academic life. Examples should show continuing leadership, not just a brief, one time-only experience.
2. Academic Achievements: Describe a situation(s) where the student has encountered academic problems or challenges, but perservered demonstrating courage, self-reliance, and determination. These challenges may be economic, physical, or environmental. Give specific examples and discuss both situation and growth experience.
3. Volunteer/Community Service or Work: Describe volunteer/community service or paid work the student has done to benefit individuals, groups, non-profit organizations, agencies, schools, or the community at large. What role did the student play, and who benefited from the community service? How many hours did the student contribute or work? How long has the student been volunteering or employed?

APPENDIX B1

 

PARENTAL/GUARDIAN AFFIRMATION
I, {parentguardianPrint}, hereby give my permission to the Little Rock Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated for {participantsName} to participate in {programName} (including planned activities), and I hereby attest, under penalty of perjury, that I have the legal authority to authorize such participation.

{parentguardianPrint}                                              {date}

 

 

WAIVER AND RELEASE

     I, {parentguardianPrint}, on behalf of {participantsName}, do hereby release, waive,discharge, covenant not to sue and agree to hold harmless Delta Sigma Theta Sorority, Incorporated (“DST”), its officers, National Executive Board, employees, members, local Chapters, representatives, agents, affiliates, and assigns (collectively “Releases”), from any and all claims, demands, and actions of any and every kind directly or indirectly arising out of, or relating in any respect to Participant Minor Child’s participation in the {programName}.

     My waiver and release of all claims, demands, actions, and liability shall include without limitation, any injury, illness, death, property damage or loss to the Participant Minor Child which may be caused by any act, or failure to act, by the Releases, unless such injury, illness, death, property damage or loss is a direct result of the willful misconduct of any Releases.

     I understand that, without limitation of the foregoing, neither Delta, nor the Program, shall be liable and each is hereby released from all claims that may arise from loss or damage to the Participant Minor Child’s personal property. 

{parentguardianPrint}                                                 {date}

APPENDIX B2
PHOTOGRAPH, MEDIA, AND VIDEO AUTHORIZATION RELEASE FORM

     I/We, {parentguardianPrint}, as parent(s) or legal guardian(s) of {participantsName}, give permission for Little Rock Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated (the “Chapter”) to publish on the Internet or media still photographs or moving images, including, if applicable any sound recordings accompanying the images (“Images”) taken of my child during participation in {programName} Youth Initiative Program activities, without payment or any consideration and without notifying me inadvance.

     I/We also give permission for the Chapter to highlight my child’s achievements and activities in efforts to promote the youth initiative program through newspapers, radio, TV, the web, DVDs, displays, brochures, and other types of media without payment or any consideration and without notifying me.

     I/We understand and agree that these Images will become the property of the Chapter, which shall have complete ownership of the Images. I hereby irrevocably authorized the Chapter to publish or distribute these Images for the purpose of publicizing the Chapter’s programs, including the {programName} Youth Initiative Program or for any other lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my child’s likeness appears. Additionally, I waive any rights to royalties or other compensation arising out of or related to the use of the Images.

   I/We hereby hold harmless and release and forever discharge the Chapter and any of its officers and members; Delta Sigma Theta Sorority, Incorporated; its officers; National Executive Board; employees; members; representatives; agents; and assigns from any and all claims, costs, suits, actions, judgments, and expenses which my child, his/her heirs, representatives, executors, administrators, or any other persons acting on his/her behalf have or may have by reason of the use of the Images. This release specifically includes, without limitation, a complete release and discharge of any liability by virtue of any editing, distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or be produced in the taking of or editing of said Images, unless it can be shown that such was maliciously caused, produced and published solely for the purpose of subjecting my child to conspicuous ridicule, scandal, reproach, scorn and indignity.

     I/we hereby certify that I/we are the parents/guardians of {participantsName}, authorized legally to give this consent, and do hereby give my/our consent without reservation to the foregoing on behalf of my/our child.

 

{parentguardianPrint}                                                         {date}

 

 

SCHOLARSHIP DISPURSEMENT PROCESS

     I, {parentguardianPrint}, on behalf of {participantsName}, do hereby understand the

• Delta Presents Scholarship Program may accept up to 15 honorees.
• Delta Presents Scholarship Award is only available for the first Fall semester following {participantsName} high school graduation. Therefore, if {participantsName} chooses not to enroll in school for the first semester, the award will be forfeited.
• Delta Presents Scholarship Award is only issued a 2-year or 4-year accredited college or university.
• Delta Presents Scholarship Award will be disbursed directly to {participantsName} based on the mailing address provided on the Enrollment Verification Form.

{parentguardianPrint}                                                 {date}

APPENDIX  A - SCHEDULE 2

MEDIA & PUBLICATION RELEASE

In accordance with the terms of the Participation Agreement, Delta Sigma Theta Sorority, Inc. (“Delta”) will be filming, recording and photographing this event for use in Delta promotional videos, photography, advertisements, social media platforms, web pages, and other future Delta events, as the case may be, (the “Production”). In addition, Delta may use and publicize the name, image, likeness, and any other personal characteristics or other information provided by or related to the Participant that is derived from the filming, recording and photographing of this event for use in Delta videos, photography, articles, as well as any advertising and promotional materials on mediums that may include on-demand, streaming, or other web services, social media platforms, and print news and information outlets, and any other the case may be (the “Publication”).

As specified within the Agreement therein, participant and participant’s parent/guardian (participant and participant’s parent/guardian together, “Participant”), via continued participation in and by continuing to remain logged into this event, hereby:

(i) acknowledges that Participant may be photographed, filmed or otherwise recorded while on the premises of the event,

(ii) grants Delta, its successors, assigns and licensees (“Authorized Persons”) irrevocable consent to include Participant’s name, likeness, photographic image, mannerisms and voice or other recording (“Media”) in any Publication or for any purpose whatsoever in any and all mediums now known or hereafter devised throughout the universe in perpetuity without compensation and/or credit,

(iii) acknowledges no right to review or approve Materials before they are used by Delta, and that Delta has no liability to me for any editing or alteration of the Materials or for any distortion or other effects resulting from Delta’s editing, alteration, or use of the Materials, or Delta’s presentation of me, should Delta choose, create or use the Materials or to exercise any rights given by this Agreement,

(iv) acknowledges that Delta is the exclusive owner of all display, publication, and ownership rights, including copyright, trademarks, and any other intellectual property, from Media and Materials arising in any jurisdiction throughout the universe in perpetuity, including all registration, renewal, and reversion rights, and the right to sue to enforce such intellectual property against infringers,

(v) acknowledges that Delta holds and shall forever hold all display, publication and ownership rights, licenses and privileges to any and all Media, whether in law or in equity, which may be asserted, ascertained, registered or in any way utilized with respect thereto,

(vi) waives all legal and equitable rights against Delta and any authorized persons relating to all liabilities, claims, demands, actions, suits, damages, and expenses, including but not limited to claims for copyright or trademark infringement, infringement of moral rights, libel, defamation, invasion of any rights of privacy (including intrusion, false light, public disclosure of private facts, and misappropriation of name or likeness), violation of rights of publicity, physical or emotional injury or distress, or any similar claim or cause of action in tort, contract, or any other legal theory, now known or hereafter known in any jurisdiction throughout the world, arising directly or indirectly from Authorized Persons ' exercise of their rights under this Release and whether resulting in whole or in part from the negligence of the Sorority, the Chapter, or any other persons, and

(vii) agree that this Agreement cannot be terminated, rescinded, or modified, in whole or in part.

Participant further agrees to abide by and comply with any and all terms of use and/or additional participation rules as applicable and specified during relevant sections of the program and acknowledges, understands, and agrees that violation of such participation rules shall result in legal recourse and disciplinary action.

 

{parentguardianPrint}                                                 {date}