2026 Debutante Ball Registration

2026 Debutante Ball Registration
Mother/Guardian Name

First NameLast Name
Mother/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother/Guardian Email Address
example@example.com
Mother/Guardian Cell
Please enter a valid phone number.
Father/Guardian Name

First NameLast Name
Father/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father/Guardian Email Address
example@example.com
Father/Guardian Cell
Please enter a valid phone number.
Debutante Name*

First NameLast Name
Debutante Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Debutante Email Address*
example@example.com
Debutante Cell*
Please enter a valid phone number.
Grade Level
High School Name
Please list two different emergency contact information:
Emergency Contact 1 Name

First NameLast Name
Emergency Contact 1 Cell
Please enter a valid phone number.
Emergency Contact 2 Name

First NameLast Name
Emergency Contact 2 Cell
Please enter a valid phone number.
Upload a letter of recommendation from one of the following (PDF):

●     Teacher

●     Church member

●     Member of Delta Sigma Theta Sorority, Inc.

●     Representative of an affiliated organization
File Upload

Cancelof
Upload copy of unofficial transcript (PDF)
File Upload

Cancelof
Escort Information
Do you have your Escort Information?

YesNo
Mother/Guardian Name

First NameLast Name
Mother/Guardian Phone Number
Please enter a valid phone number.
Mother/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother/Guardian Email
example@example.com
Father/Guardian Name

First NameLast Name
Father/Guardian Cell Number
Please enter a valid phone number.
Father/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father/Guardian Email
example@example.com
Escort Name

First NameLast Name
Escort Email
example@example.com
Escort School
Escort Grade Level
Escort Cell Number
Please enter a valid phone number.
Please list two different emergency contact information:
Emergency Contact 1 Name

First NameLast Name
Emergency Contact 1 Number
Please enter a valid phone number.
Emergency Contact 2 Name

First NameLast Name
Emergency Contact 2 Number
Please enter a valid phone number.
Upload a letter of recommendation from one of the following (PDF):

●     Teacher

●     Church member

●     Member of Delta Sigma Theta Sorority, Inc.

●     Representative of an affiliated organization
File Upload

Cancelof
Upload copy of unofficial transcript (PDF)
File Upload

Cancelof
My Products
prevnext( X )
Debutante Ball Registration
$250.00

Subtotal

$0.00

Tax

$0.00

Shipping

$0.00

Total

$0.00
There is a 3.52% + $0.98 transaction fee for online payments.

Funds can also be mailed to the Delta Centet at the address below:

Attention: Debutante Ball

1012 S. 15th Street

East St. Louis, IL 62207

or you can email eslacdebball@gmail.com for an in-person collection date.
Should be Empty: