Atwater-Merced Alumnae Chapter - 2025-2026 Delta Academy/Delta G.E.M.S Application Form
Parent Orientation/Information Meeting will be held virtually on September 9, 2025. Please complete this application by September 19, 2025.
Students Information
Please complete the form in its entirety. If there is a question that does not apply, please write N/A.
First Name
*
Middle Initial
*
Last Name
*
Date of Birth (Month/Date/Year)
*
Mobile Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
I accept SMS Text alerts to receive our latest news, reminders, and promotions. MSG frequency varies. I understand that my own mobile carriers may apply data rates. I can opt out at any time, by contacting the Youth Programs of Atwater-Merced Alumnae Chapter.
*
Yes
No
Student Email Address
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Student's Education
Please complete the form in its entirety. If there is a question that does not apply, please write N/A.
Official School of Attendance
*
Graduation Year
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade Level
*
Please Select
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
What is your current overall GPA?
*
Have you participated in a Delta Academy before?
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Yes
No
If yes, in what year did you first participate?
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Have you participated in Delta G.E.M.S before?
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Yes
No
If yes, in what year did you first participate?
*
Do you plan to attend college?
*
Please Select
Yes
No
Unsure
If yes, what are your current top 5 college choices?
*
If no, what do you plan to do after high school?
*
Are you the first in your family to attend or potentially graduate from college?
*
Please Select
Yes
No
Unsure
What are your future career aspirations?
*
I participate in the following extracurricular programs and activities during and after school: (Please list all of them). (Write N/A if you do not have any extracurricular or activities)
*
I have or currently hold the following leadership position in the extracurricular activities. (Write N/A if you have not had any).
*
Adult T-Shirt Size
*
Please Select
Extra Small
Small
Medium
Large
XLarge
2XLarge
3XLarge
4XLarge
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Parent/Guardian Information
Please complete the form in its entirety. If there is a question that does not apply, please write N/A.
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I accept SMS Text alerts to receive our latest news, reminders, and promotions. MSG frequency varies. I understand that my own mobile carriers may apply data rates. I can opt out at any time, by contacting the Youth Programs of Atwater-Merced Alumnae Chapter.
*
Yes
No
Parent/Guardian Email
*
example@example.com
Parent Guardian 2 Name (if applicable)
First Name
Last Name
Parent/Guardian 2 Mobile Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I accept SMS Text alerts to receive our latest news, reminders, and promotions. MSG frequency varies. I understand that my own mobile carriers may apply data rates. I can opt out at any time, by contacting the Youth Programs of Atwater-Merced Alumnae Chapter.
Yes
No
Parent/Guardian 2 Email
Please enter a valid phone number.
Format: (000) 000-0000.
Upload Important Documents
Please upload your current transcripts
*
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Please upload your completed parent/guardian forms. You can complete them via the link located at https://linktr.ee/amacyouthprograms OR at 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 of me or my child at all activities and I release and hold harmless the parties listed above from any and all liability from such use and publications. I further authorize the editing, alteration, reproduction, copyright, exhibit,broadcast, electronic storage and distribution of said photographs / film /videotapes /electronic representations and/or sound recordings at the discretion of of the parties listed above and I waive any right to any compensation that I may have for any of the foregoing. I have read this statement and fully understand its terms and sign it freely and voluntarily
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Yes
No
Authorized Parent/Guardian Signature confirming you understand all of the above, including the completed forms, and you said yes to the above question.
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