Clone of SITC Omega Gents application

SITC Omega Gents Application

The Omicron Gamma Gamma Chapter (OGG) of Omega Psi Phi Fraternity, Inc. and the See It Through Charities Foundation jointly provide mentoring services through the “Omega Gents” Mentoring Program. The mentoring program accepts young men from ages 10-15 years of age and operates on yearly basis with two terms during the year. Applications form membership are accepted annually in April for an August start date. Application does not guarantee membership.
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

CityState / Province

Postal / Zip Code
Mobile Number*
Format: (000) 000-0000.
Student E-mail*
example@example.com
Are you a US Citizen?*

YesNo
What is your race?*
What is gender?*
Parent/Guardian Name *

First NameMiddle NameLast Name
Address*

Street Address

CityState / Province

Postal / Zip Code
Parent/Guardian Number*
Format: (000) 000-0000.
What is the name of your school?*

Street Address

CityState / Province

Postal / Zip Code
What is your grade?*
Total number in household?*
Age of children in household?*
What is your reason for wanting to be an Omega Gent?*
What are your interests?*
What sports do you participate in?*
Are you a member in any other mentor programs or organizations?*
How much time do you have to donate to the program?*
Who referred you?*
Are you available for a personal or phone interview with the selection committee?*

YesNo
Note to Students: Code of Conduct Students are expected to: 1. Display great character and integrity at all times. 2. Show respect to instructors and peers. 3.Maintain a safe and inclusive environment. 4. Engage actively and responsibly in all activities. 5. Demonstrate teamwork and leadership in group projects. Student's signature required.*
Our goal is to provide a safe and enriching learning environment. While we strive to accommodate each child, we may not be able to meet all individual needs. We reserve the right to remove any student for disruptive behavior or violations of the Code of Conduct. Acknowledgment & Consent By participating, students and parents agree to responsible internet use and grant permission for the student's name, image, and likeness to appear in program materials, including the website, social media, and promotional content. Indemnity Agreement, the undersigned participant (or parent/guardian of a minor), assume all risks associated with the Omega Gents program and release its organizers, sponsors, and affiliates from any liability related to participation, including technology use, activities, and media publication. Parent/guardian signature required*
Should be Empty:

SITC Omega Gents Application