PGCAC MISS COTILLION APPLICATION

PGCAC MISS COTILLION APPLICATION
MISS COTILLION

APPLICATION INSTRUCTIONS:

In order for your daughter to be considered for selection as a Miss Cotillion Contestant she must:
- Be a high school junior or senior during the 2024-2025 school year;
- Have never been married, has no children and not be an expectant mother during the Cotillion program timeframe (September 2024 – May 2025);
- Have not experienced any expulsions or out of school suspensions within the past two years;
- Have a 2.5 cumulative, high school grade point average (GPA) in her previous school year. Juniors will use her cumulative, sophomore year GPA / Seniors will use her cumulative junior year GPA.
A completed Miss Cotillion Contestant application packet will include the following:
1. Completed application
2. Official high school transcript
3. A $250.00 fee is due at the time of application. The remaining $500 of the participation fee will be due, November 1st ($250) and December 1st ($250). (Note: The fees are non-refundable)
4. A recent, printed (5x7) color portrait photograph (No proofs, cell phone, personality, or scanned photos). Please note that the photo becomes the property of PGCAC DST.
5. An essay (350-500 words, typed in Times New Roman, doubled spaced) on “How My Participation in the Cotillion Program Will Help Create My Destiny."
6. Two letters of recommendation. One letter must be from a school official (on school’s letterhead) and the other can come from a school, community, church official (on organization’s letterhead), or a financially active member of Delta Sigma Theta Sorority, Inc.
In addition to the application fee, there are other costs associated with participating in the Cotillion Program. The additional costs include, but are not limited to: (1)formal wear for the contestants and their escorts, (2) the parents’ tickets for the Cotillion and (3) a risk management background check fee. To ensure that the Cotillion program is conducted in a safe environment, you/the parent(s) of the participant and any escort over the age of 18 is required to complete our background check screening process. The fee for this process is no more than $50 per person and these fees are non-refundable. This process will take place after your daughter is accepted into our program.

We are excited about your interest in participating and look forward to a wonderful and fun-filled Cotillion year.

Please e-mail any questions you may have to the Cotillion Committee: Cotillion@pgcacdst.org.

Note: APPLICATION DEADLINE: Sunday, September 1, 2024 electronically by midnight

A checklist is provided at the end of this form to ensure application completeness. All information is considered confidential. All materials, including the photo become the property of PGCAC DST.

2024-2025 Miss Cotillion Application
Parental Permission to Participate

• Be certain all questions are answered completely.
• Recent, printed (5x7) color portrait photograph. (No proofs, cellphone, personality, or scanned photos).
• Final report card from 2023-2024 school year.
• Two letters of recommendation typed, signed and dated. One letter must be from a school official (on school letterhead) and the other can come from a school, community, church official (on organization's letterhead) or a financially active member of Delta Sigma Theta Sorority, Inc.
• Submit $250 application fee electronically.

**If any items are omitted, the application will be deemed incomplete and will not be considered**

2024-2025 Miss Cotillion Application
Applicant's Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email Address:*
example@example.com
Date of Birth:*

MonthDayYear
Date
Age:*
School:*
GPA:*
Grade:*
Mother's Name:

First NameLast Name
Home Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email Address:
example@example.com
Father's Name:

First NameLast Name
Home Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Guardian:

First NameLast Name
Home Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email Address:
example@example.com
Emergency Contact:*

First NameLast Name
Home Phone:*
Please enter a valid phone number.
Cell Phone:*
Please enter a valid phone number.
Email Address:*
example@example.com

6. Attach Essay: "How My Participation in the Cotillion Program will Help Me Create My Destiny" *

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7. List all extracurricular activities (please include community activities, public service projects and interests)*
8. What talents do you have? Include things such as playing a musical instrument, singing, dancing, acting, public speaking, designing, poetics, dramatic reading, etc. *

Transcript - Please upload your 2023-2024 official school year transcript*

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Photo Upload - Please upload a recent, printed (5x7) color portrait photograph (No proofs, cell phone, personality, or scanned photos.). Please note that the photo becomes the property of PGCAC DST.*

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Recommendation Letters - Please upload two (2) letters of recommendation*

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Parental Permission to Participate
I give permission for my daughter Full Name* to participate in the Cotillion Program.
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date

CHECKLIST
Be Certain all questions are answered completely.Typed essay detailing “How My Participation in the Cotillion Program Will Help Me Create My Destiny." (12-point,Times New Roman font, double-spaced 350-500 words).Recent, printed (5x7) color portrait photograph. (No proofs, cellphone, personality, or scanned photos).Electronic transcriptTwo letters of recommendation typed, signed, and dated. One letter must be from a school official (on school letterhead) and the other can come from a school, community, church official (on organization’s letterhead), or a financially active member of Delta Sigma Theta Sorority, Inc.Submit $250.00 application fee electronically.
**If any items are omitted, the application will be deemed incomplete and will not be considered**
Should be Empty:

PGCAC MISS COTILLION APPLICATION

2024-2025 Miss Cotillion Application

Parental Permission to Participate

CHECKLIST