The Alpha Esquires Program Application

The Alpha Esquires Program Application

Alpha Phi Alpha Fraternity, Inc. Kappa Psi Lambda Chapter Kalamazoo Michigan
Deadline to apply is Sunday February 2nd, 2025 11:59pm

Prepare a 250 word written essay on Why you Want to Be an Alpha Esquire? What do you hope to gain from the Alpha Esquire program? And What are your academic and career goals?

Please Submit your Essay Below
Full Name

First NameLast Name
Alpha Esquire Essay

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Photo Headshot

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Date of Birth

MonthDayYear
Date
Age
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
Shirt Size

SmallMediumLargeX Large2XL
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current School
Current Grade

FreshmanSophomoreJuniorSenior
Current GPA
Parent/Guardian Information

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical Information/ Does the applicant have any medical condition(s) or take any medication(s)?
I consent for the release of any media production related to my voice, picture and/or likeness and reproductions in any form with or without alterations or omissions by Alpha Esquires program of Kalamazoo, for the purpose of advertising, purpose of trade or for such purposes of a similar nature as it may be deemed necessary and advantageous. This release is irrevocable.
I understand that involving my son in the community is an integral part of programming for the Alpha Esquires program. I grant permission to the staff to take my son into the community for educational, vocational, and social/recreational activities. This may include the use of various transportation modes including but not limited to public transportation, chartered bus, or agency vehicle. I understand notices will be sent to me regarding each scheduled activity. If there is a specific event, I do not want my son to participate I may call or write to revoke my permission. My permission as expressed in this release is valid for the duration of my child’s enrollment in the Alpha Esquire program.
Applicant Signature

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Parent/Guardian Signature

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