67th Annual Cinderella Ball Debutante Application

67th Annual Cinderella Ball November 27, 2026

Debutante Application Deadline for submission is July 1, 2026
APPLICATIONS MAY BE SUBMITTED VIA:
1. Electronically via jotform: https://form.jotform.com/260423678968169

General Instruction and Qualifications for Applications:
- A letter from your school on the school’s letterhead documenting your Grade Point Average (GPA Your GPA must be 2.00 or better.
- Applicant must be either a High School Freshman, Sophmore, Junior or Senior in the Fall.
- Three adult references are required.
- Applicant and escort must be single and a non-parent.
- Applicant must have at least one parent of African American origin.
- An application fee of seventy-five ($75) dollars is due at the Debutante’s Orientation. (Includes debutante and escort fee. After each debutante has been accepted, no fees can be refunded.)
DEBUTANTE’S PERSONAL INFORMATION:
Full Legal Name:
Age
Is at least one parent of African American origin?:
Permanant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Personal E-Mail Address
example@example.com
Attending High School Name
Parent(s)/Guardian(s) Name
Email Address
example@example.com
Telephone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
EDUCATIONAL INFORMATION: Please attached a letter from your middle school or high school on the school’s letterhead documenting: School Name, Address and documenting your Grade Point Average (GPA). The letter must be signed by the Principal or Guidance Counselor.
Letter from Middle School or High School

Cancelof
ESCORT’S PERSONAL INFORMATION:
Full Legal Name:
Age:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Personal E-Mail Address
example@example.com
Personal E-Mail Address
example@example.com
Attending High School Name
Parent(s)/Guardian(s) Name
Email Address
example@example.com
Telephone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.

ADULT REFERENCES:

Rows	NAME	ADDRESS, CITY, STATE, ZIP CODE	PHONE NUMBER

EXTRACURRICULAR ACTIVITIES:
YOUTH ORGANIZATION AFFILIATIONS:
CAREER GOALS
AWARDS AND HONORS
If yes, please list Junior Civic League member’s name and relationship:
JCL Member Name
Relationship to JCL Member
In signing this application, I certify that the information given is complete and correct to the best of
Signature of Applicant
Date

MonthDayYear
Date
Junior Civic League, P.O. Box 243, Youngstown, OH 44501
Should be Empty:

67th Annual Cinderella Ball November 27, 2026

APPLICATIONS MAY BE SUBMITTED VIA:

DEBUTANTE’S PERSONAL INFORMATION:

ESCORT’S PERSONAL INFORMATION: