College Admissions Form

Delta Sigma Theta Sorority Inc. San Diego Alumnae Chapter Delta G.E.M.S. Application Form

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Student's Information
Name*

First NameMiddle InitialLast Name
Birth Date*

MonthDayYear
Mobile Phone*
Student's E-mail Address*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student's Education
Official High School or Equivalent Name*
High School Graduation Date*

MonthDayYear
Date
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grade Level*
What is your current overall GPA?*
Have you participated in Delta G.E.M.S. before?*
If yes, in what year did you first enter?
Have you participated in Delta Academy before?*
Are you the first in your family to attend or graduate from college?*
Do you plan to attend college?*
If yes, what are your top 5 college choices*
What are your future career aspirations?*
I participate in the following extracurricular programs and activities during and after school: (Please list all of them)*
I have held or currently hold the following leadership positions in the extracurricular activities:*
Adult T-Shirt Size:*

Parent & Guardian Information
Parent / Guardian Mother's Name*

First NameLast Name
Parent / Guardian Mother's Mobile Phone Number*
Please enter a valid phone number.
Parent / Guardian / Mother's Email*
example@example.com
Parent / Guardian / Father's Name*

First NameLast Name
Parent / Guardian / Father's Mobile Phone Number*
Please enter a valid phone number.
Guardian / Father's Email*
example@example.com
Upload Important Documents
Please upload your latest transcripts*

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Please upload your parental/guardian forms by copying and pasting this chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://files.constantcontact.com/33d214b6be/16016eac-7f2f-4b27-a706-1164eadb9368.pdf*

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I approve of my child participating in this program and assign and grant to organization, its chapter, its partners, the right and permission to use and publish the photographs / film /videotapes/electronic/likeness/representations and/or sound recordings made ofme or my child at all activities and I release and hold harmless the partieslisted above from any and all liability from such use and publications. Ifurther authorize the editing, alteration, reproduction, copyright, exhibit,broadcast, electronic storage and distribution of said photographs / film /videotapes /electronic representations and/or sound recordings at thediscretion of of the parties listed above and I waive any right to anycompensation that I may have for any of the foregoing. I have read thisstatement and fully understand its terms and sign it freely and voluntarily.*

YesNo
Signature (If you said yes above, and you are the authorized parent or guardian, please sign.)*

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Delta Sigma Theta Sorority Inc. San Diego Alumnae Chapter Delta G.E.M.S. Application Form

Student's Information

Student's Education

Parent & Guardian Information

Upload Important Documents