2025-2026 Jeanne L. Noble Delta GEMS Application

The primary goal of the Dr. Jeanne L. Noble Delta GEMS Program is to prepare our youth for full participation as leaders in the 21st Century. Approximately 22 young scholars participate each year in varied activities including, but not limited to: self-esteem, etiquette, career workshops, college tours, a retreat, special outings to cultural events, and community service such as feeding the homeless and walk-a-thons. Their active participation is essential to planning and implementing such programs throughout the school year. GEMS participants will engage in a variety of public service and fun filled activities. These experiences and interactions will significantly help to increase their leadership abilities, communication skills, and community awareness.

The Delta GEMS is designed for young women who meet the following criteria:

▲ High School students who identify, grades 9-12

▲ Resides or attends school in Westchester County

▲ Demonstrates great academic and personal promise

▲ Shows interest in developing leadership skills

▲ Shows interest in pursuing a higher or secondary education

▲ Shows interest in community action and social change

▲ Commitment to the program for the entire academic year

Delta GEMS Mentoring Sessions will launch in October 2025 through May or June 2026, beginning with the required Parent and Youth Orientation to be held virtually on Thursday, October 2, 2025 at 7:30pm. Both parent/guardian and youth are required to attend the orientation.

The Delta GEMS first in-person mentoring session will also begin in October 2025 - date to be announced. Subsequently, the sessions will take place on the second Saturday.

Meeting Location - to be announced.

Time: 11:00am- 2:00pm

Any session date changes will be communicated to all participants and parents.

APPLICATION PROCESS/ DEADLINE

Please carefully read the application instructions below before completing the application.

▲The Dr. Jeanne L. Noble Delta GEMS Committee of Westchester Alumnae Chapter will select approximately 22 participants based upon their demonstrated leadership and personal development ability as well as the above listed requirements.

▲ Applications will be accepted through September 30, 2025 or until we reach capacity.

▲ Parent & Youth Orientation will be held virtually on Thursday, October 2, 2025 at 7:30pm. There will be a follow up with the RSVP zoom link for this orientation.

▲ If you have any questions or concerns regarding the program or the application please feel free to contact the Westchester Alumnae Chapter Dr. Jeanne L. Noble Delta GEMS Chairpersons at gems@dstwac.org.
STUDENT INFORMATION
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

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

MonthDayYear

ACADEMICS
High School Name*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grade*
Grade Point Average (Most Current)*
If any, what are some of the colleges you are interested in? (SUNY, CUNY, HBCU, Out of State etc.)*

Extracurricular Activities/Achievements/Hobbies
Please list all extracurricular activities, accomplishments/recognitions you have achieved or received including hobbies*
What activities, if any, would you like to see the program participate in and/or topics for us to touch on this year?*

PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Transportation: Participation in the GEMS Program will require meeting at the Grinton I Will Public Library in Yonkers and may require travel to various location throughout Westchester County. Please enter the method of transportation for your daughter. *
Cell Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Relationship to Student*
How did you hear about the Dr. Jeanne L. Noble Delta GEMS Program?*
What are you hoping your child takes away from the Dr. Jeanne L. Noble Delta GEMS Program?*
Please download and review all (13) documents and sign and upload Appendix B1-9B, B10.

(1) Appendix B1: Parental/Guardian Affirmation

(2) Appendix B2: Photograph, Media, and Video Authorization Release

(3) Appendix B3: Youth Code of Conduct for In‐Person Meetings

(4) Appendix B4: Youth Pick‐up Authorization

(5) Appendix B5: Waiver and Permission to Transport Youth

(6) Appendix B6a & 6b: Parent Waiver and Permission for Youth To Be Transported by Teenage Driver

(7) Appendix B7: Off‐site Permission

(8) Appendix B8: Medical and Emergency Contact Information

(9) Appendix B9, B9.1, B9.2: Virtual Meeting/Event Participant Agreement

(10) Appendix B10: Parent/Guardian Acknowledgement Of Informational Forms

(11-13) Appendix B11, B12, B13: Confidentiality Policy, Youth Sign‐In/Sign‐Out Policy, Internet Youth Policy

Please continue to the next page to download all required forms.

Required Documents
File Upload *

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Essay Question:

Why do you want to be a member of GEMS? What do you hope to contribute to the GEMS program? (250 word maxium)
File Upload*

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Should be Empty:

STUDENT INFORMATION

ACADEMICS

Extracurricular Activities/Achievements/Hobbies

PARENT/GUARDIAN INFORMATION