Delta VIOLETS Application

2025-2026 Delta VIOLETS Application
Welcome to Delta VIOLETS' Online Application!

We are excited that you are considering joining our mentoring group. Please take a few minutes to complete the application by Saturday, October 25, 2025.

Delta VIOLETS Chairs:

Ms. Tiffany Simone Nelson, Chair
Ms. LaQuita Lucas, Co-Chair

The 2024 Mentorings Groups Orientation and Risk Management Training is Saturday, September 13, 2025.

Meeting Location: Miami Central Sr. High School

Contact Us at deltavioletsmac@gmail.com

2025-2026 Delta VIOLETS Application
- Name*
  
  First NameLast Name
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Home Number
  Please enter a valid phone number.
- Cellular Number
  Please enter a valid phone number.
- Applicant Email
  example@example.com
- Date of Birth*
  
  MonthDayYear
  Date

2025-2026 Delta VIOLETS Application
- Parent/Guardian Name*
  
  First NameLast Name
- Contact Number*
  Please enter a valid phone number.
- Alt. Number
  Please enter a valid phone number.
- Parent/Guardian Email*
  example@example.com
- Parent/Guardian Name #2 (Optional):
  
  First NameLast Name
- Contact Number
  Please enter a valid phone number.
- Alt. Number
  Please enter a valid phone number.
- Parent/Guardian Email #2
  example@example.com

2025-2026 Delta VIOLETS Application
- Does the applicant have any allergies?
  
  YesNo
- List any drug allergies:
- List any food allergies (i.e., watermelon, peanuts, etc.)
- List any substances allergies (i.e., dust, pollen, etc.)
- List any animal allergies (i.e., dogs, cats, etc.)
- Please sign below. Your signature will indicate that you and your violet have read, understand, and will adhere to all of the items in this packet.
- Violet's Name*
  
  First NameLast Name
- Date*
  
  MonthDayYear
  Date
- Parent/Guardian Signature*
- Date*
  
  MonthDayYear
  Date

2025-2026 Delta VIOLETS Application
- Emergency Contact #1*
  
  First NameLast Name
- Relationship*
- Contact Number*
  Please enter a valid phone number.
- Email*
  example@example.com
- Emergency Contact #2
  
  First NameLast Name
- Relationship
- Contact Number
  Please enter a valid phone number.
- Email
  example@example.com
- If for any reason I/we cannot be reached, please contact the following person(s) whom I/we hereby authorize to seek emergency medical or surgical care for my/our child.
- Name*
  
  First NameLast Name
- Relationship*
- Contact Number*
  Please enter a valid phone number.
- Email*
  example@example.com
- In the event that the Program is unable to reach any of the individuals named above promptly by phone, I/we authorize the Program to seek and secure any emergency medical or surgical care for my/our child. I/We will be responsible for any and all expenses incurred and authorize the medical facility at which treatment is rendered to release all necessary information to my/our insurance company.
- Parent/Guardian Signature*
- Date*
  
  MonthDayYear
  Date
- Parent/Guardian Signature
- Date
  
  MonthDayYear
  Date

2025-2026 Delta VIOLETS Application
DELTA VIOLET-PARENT-MENTOR CODE OF CONDUCT

Miami Alumnae Chapter seeks to provide a safe and exciting atmosphere for girls to learn more, explore new things, grow in weak areas and most importantly be free to be themselves. Please read below and sign this form.

As a Violet, I will

♦ Be RESPECTFUL to myself, my peers, family, and adults

♦ Use appropriate language and tone with others

♦ Be helpful, clean, honest, and kind at ALL TIMES

♦ Be ON TIME to meetings and events

♦ Complete my take home activities and have fun doing them

♦ Resolve conflict peacefully with the help of the Delta Violet Mentors

♦ BE THE BEST VIOLET I CAN BE

As a Parent, I will

♦ Bring my Violet REGULARLY to all meetings and events. If this cannot occur, I will notify the appropriate mentor in advance

♦ Drop off and Pick Up my Violet ON TIME from all meetings and events.

♦ Assist my Violet with completing all fun take home activities

♦ Be respectful of those volunteering their time as mentors, respectfully bringing all concerns and comments to Delta Violet Mentors

♦ Abstain from posting pictures/photo/video of other Violets, Mentors and Parents on social sites (i.e., facebook, my space, you tube, etc.)

♦ Refrain from bringing guests/relatives to closed events & meetings without prior approval

As Mentors, I will

Respect all participants (other youths and adult volunteers) by not using foul, hurtful or obscene language or engaging in physical violence, bullying (including cyber-bullying)₁or other aggressive behaviors that threaten the safety of others.

♦ Be ON TIME to meetings and events

♦ Provide ample notification of calendar changes (at least 5 days)

♦ Respectfully bring concerns and comments to Parents and Violets

♦ Keep information about Violets confidential

♦ Use pictures/photos/video of meetings and activities for Chapter use only (i.e. website, recruitment flyers)

I am excited to join Delta Violets and I look forward to all the wonderful experiences ahead. By signing below, I agree to fulfill my responsibilities:

With my parent or other adult, I have read the Code of Conduct and sanctions for violating the Code. I understand the Code and the sanctions. I will follow the Code of Conduct.

As a Violet {name}

**************

I understand that my child’s compliance with the Code of Conduct is a condition of her/his participation in the Delta Violet program. I agree that the sanctions for violating the Code of Conducts are reasonable and will help my child comply.
Parent's Name*

First NameLast Name
Parent's Signature*
Date*

MonthDayYear
Date

2025-2026 Delta VIOLETS Application
Youth Pick-up Authorization Form
Phone Number
Please enter a valid phone number.
I, parent/guardian name , authorize the persons listed below to pick-up my child from the Delta Violets youth initiatives program. For my child’s safety, I understand
that all authorized persons on the list below will be asked to show photo identification before my child is released to them; therefore, I will notify all authorized persons of this requirement so that they will have photo identification with them when they arrive to pick-up my child. (Please include names of either parents or guardians on list below).
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.

2025-2026 Delta VIOLETS Application
PHOTOGRAPH AND VIDEO AUTHORIZATION AND RELEASE FORM

Dear Parent or Guardian:

Please be advised that during this year your child may be photographed, videotaped, or interviewed during the various activities or events. With your consent, the photograph, video, or interview may be reproduced and released for use of the sorority, newspaper, or brochures. Please indicate below:

Violet's Name: {violetsName}
Yes, my child's photograph/video/interview may be reproduced for use by the sorority
No, my child's photograph/video/interview may be reproduced for use by the sorority
Parent/Guardian Name #1*

First NameLast Name
Signature*
Date*

MonthDayYear
Date
Parent/Guardian Name #2

First NameLast Name
Signature
Date

MonthDayYear
Date
Should be Empty:

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

2025-2026 Delta VIOLETS Application

Youth Pick-up Authorization Form

2025-2026 Delta VIOLETS Application