Delta GEMS Participant Registration
2026-2027
The Dr. Jeanne L. Noble Delta GEMS Institute was created to catch the dreams of African American at-risk, adolescent high school girls aged 14-18. However, participation is not limited to African Americans. “Delta GEMS provides the framework to actualize those dreams through the performance of specific tasks that develop a CAN-DO attitude”. Goals for Delta GEMS consist of instilling the need to excel academically, providing tools for academic success, assisting with proper goal setting and planning for high school and beyond and creating compassionate, caring community minded young women.
SECTION 1: PARTICIPANT INFORMATION
Thank you for your interest in the Delta GEMS program. Please click on this link to complete your registration and payment. Thank you.
Participant Name:
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First Name
Last Name
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Participant Age (Fall 2026):
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Participant Email Address:
This will only be used to provide program information and updates.
Participant Date of Birth (M/D/YYYY):
*
Participant Grade Level (Fall 2026):
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Participant School (Fall 2026):
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City/County of:
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Is your mother a member of Delta Sigma Theta Sorority, Inc.?
*
No
Yes
Are You a Returning Participant?
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Yes
No
If Yes, List Previous Years
If Yes, List any previous location(s):
Participant's T-Shirt Size (Select One)
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Please List Any Allergies (If None Write N/A)
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Participant Three Favorite Items
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Participant Favorite Subject
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Participant Favorite Hobby / Interest
*
SECTION 2: PARENT INFORMATION
Parent/Guardian Name:
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First Name
Last Name
Phone Number (Home):
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Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number (Cell):
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address:
*
Please do not use work email addresses. This will be used to provide program information and updates.
Primary Emergency Contact (if different from above)
*
Primary Emergency Contact Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
SECTION 3: PAYMENT INFORMATION
Payment:
*
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Delta GEMS (High School Ages 14-18)
Please note, this fee is non-refundable.
$25.00
$
25.00
Quantity
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