2026-2027 Dr. Jeanne L. Noble GEMS Institute Application

The Dr. Jeanne L. Noble GEMS Institute

2026-2027 Application Deadline - July 1, 2026 5PM
Please read and follow the instructions carefully prior to submitting your application. Participants selected will be notified on or before August 10, 2026.

This application is for rising 9th-12th grade young ladies in the 2026-2027 school year.

All correspondence will be generated from the personal information submitted below. Please check that all information and email addresses are correct including any capitalization and punctuation.

**Parent #1 will be the primary contact
I. Student Data

Tell us about yourself
Name:

First NameMiddle NameLast Name
Cell Phone Number:
Format: (000) 000-0000.
May we text you using the cell phone number listed?
E-mail Address:
An active email address is required for all participants.
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
II. High School Information:
Name of School for 2026-2027 School Year:
School

Other
Grade Level for 2026-2027 School Year:
Please select one option.
Age:
This upcoming year will be my_____ year participating in Delta GEMS.
Choose One.
Were you ever a participant in Delta Academy? (Choose one.)
Is your mother, or grandmother a member of Delta Sigma Theta Sorority, Incorporated?
If your mother, or grandmother is a member of Delta Sigma Theta Sorority, Incorporated, please provide the name and your relationship to the member.
III. Parent / Guardian Information
Parent / Guardian #1 Name:

First NameLast Name
Parent / Guardian #1 E-mail Address:
An active email address is required for all participants.
Parent / Guardian #1 Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian #1 Mobile Number:
Format: (000) 000-0000.
Parent / Guardian #2 Name:

First NameLast Name
Parent / Guardian #2 E-mail Address:
An active email address is required for all participants.
Parent / Guardian #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian #2 Mobile Number:
Format: (000) 000-0000.
IV. High School Extra-Curricular Activities

List all current and past activities you were/are involved with while in high school.
Please provide a list of ongoing activities in which you will be engaged during the 2026-2027 school year (e.g. clubs, sports, jobs, business, church and community activities).
Please indicate which of the following activities would be of most interest to you as part of the program:

Other
Meetings are usually held on the 3rd Saturday of each month for approximately 2 hours, are you able to meet this commitment? (Choose one.)
V. Written Response

Please respond to the question that is applicable to your G.E.M.S. status
New G.E.M.S. Applicant Only

Why do you want to be a part of the Delta G.E.M.S. program? What do you hope to learn or gain by participating in the program? Your response should be no more than 500 words.
Essay:

Your response should be no more than 500 words in the space above.0/500
Returning G.E.M.S. Applicant Only

As a returning member, there is an expectation of engaged participation. Explain how you plan to be more engaged and be an ACTIVE participant of Delta G.E.M.S.? Your response should be no more than 500 words.
Essay:

Your response should be no more than 500 words in the space above.0/500
VII. Applicant E-Signature
By signing in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature
Date:

MonthDayYear
VIII. Parent E-Signature
By signing in the space below, you are certifying that all information is correct and that you are the Parent/Guardian of the participant named above completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature
Date:

MonthDayYear
Charlotte Alumnae Chapter Delta Sigma Theta Sorority, Incorporated
Should be Empty:

The Dr. Jeanne L. Noble GEMS Institute

I. Student Data

II. High School Information:

III. Parent / Guardian Information

IV. High School Extra-Curricular Activities

V. Written Response

VII. Applicant E-Signature

VIII. Parent E-Signature

Charlotte Alumnae Chapter Delta Sigma Theta Sorority, Incorporated