EMBODl PARTICIPANT REGISTRATION
2026-2027
The EMBODI (Empowering Males to Build Opportunities for Developing Independence) program is designed to refocus the efforts of Delta Sigma Theta Sorority, Incorporated, with the support and action of other major organizations, on the plight of African-American males aged 11-18. Both informal and empirical data suggests that the vast majority of African-American males continue to be in crisis and are not reaching their fullest potential educationally, socially and emotionally. EMBODI is designed to address these issues through dialogue and recommendations for change and action. EMBODI addresses issues related to STEM education, culture, self-efficacy, leadership, physical and mental health, healthy lifestyle choices, character, ethics, relationships, college readiness, fiscal management, civic engagement and service learning.
SECTION 1: PARTICIPANT INFORMATION
Thank you for your interest in the EMBODI program. Please click on this link to complete your registration and payment. Thank you.
Student Name:
*
First Name
Last Name
Street Address:
*
No P.O. Box
City:
*
Zip Code:
*
Age (Fall 2026):
*
(in years)
Name of School (Fall 2026):
*
Grade Level (Fall 2026)
Allergies (If none, write N/A):
Date of Birth:
*
MM/DD/YYYY
Favorite Hobbies or Interests:
SECTION 2: PARENT INFORMATION
Parent Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent's Email Address:
*
Please include PERSONAL email address only. Work email addresses not allowed.
Primary Emergency Contact (If different from above):
First Name
Last Name
Primary Emergency Contact Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Emergency Contact:
First Name
Last Name
Secondary Contact Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
SECTION 3: PAYMENT INFORMATION
SECTION 4: PAYMENT
Registration Payment Information:
*
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EMBODI Fee (Non-Refundable) $25.00
$25.00
$
25.00
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