Alpha Beautillion Participation Application 26-27
Thank you for your interest in participating in the Alpha Beautillion. Please complete the following application to be considered for this distinguished event. All information will be kept confidential and used solely for selection purposes.
First Name
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Last Name
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Street Address
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City
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State/Province
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Zip/Postal Code
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Preferred Phone Number
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Preferred Email Address
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Date of Birth
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Month
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Day
Year
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High School Name
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Current Grade Level
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Senior
Junior
Will you be a May, 2027 Graduate?
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Yes
No
Current Cumulative GPA
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Class Rank
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Are you a 1st Generation College Student?
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Yes
No
Preferred way of Contact
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Email
Phone
Both
Race
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Black/African America
White
Hispanic/Mexican American
Asian
Native Hawaiian/Pacific Islander
Native American
Other
T Shirt Size
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XS
S
M
L
XL
XXL
Other
High school activities, community service activities, honors, trophies held, and/or offices held.
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Mother/Mother Figure Name
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Preferred Phone Number
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Preferred Email Address
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Preferred way of contact
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Email
Phone
Both
Father/Male Father Figure Name
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Preferred Phone Number
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Preferred Email Address
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Preferred Way of Contact
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Email
Phone
Both
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Why would you like to participate in the Alpha Beautillion?
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Have you submitted a college application?
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Yes
No
What schools have you applied to? (If junior put N/A)
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What is your preferred area of study?
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I fully understand and appreciate that the Alpha Beautillion program is an out-of-school time program designed to enrich my life through educational, civic and social seminars and activities. I commit to this program because I believe it will benefit myself, fellow beaux, and my community. I understand that this partnership will work only with the full participation of myself, my parents and the Brothers of the Beta Tau Lambda Chapter of Alpha Phi Alpha Fraternity, Inc.Therefore I will: Be present and on time for all workshops, events & rehearsals.Commit my full attention to the workshopsCommit my full energies to raising funds through soliciting support of family, friends and the communityComplete college applications in a timely manner and make full preparations to attend college in Fall, 2027.Today, with my parents and the Brothers of the Beta Tau Lambda chapter of Alpha Phi Alpha Fraternity, Inc. I fully commit to the Alpha Phi Alpha Beta Tau Lambda Charitable Foundation (BTLCF) Alpha Beautillion Program
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I agree
Digital Signature (Fully Typed Name)
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Today's Date
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Month
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Day
Year
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I understand that the success of this program involves my active participation from beginning to end. As a parent and partner I will: Ensure my son’s timely attendance at workshops, community service projects and social activities Commit early to Fund-raising through friends, family, and the community, Ensure my son follows the rules and guidelines outlined in the Alpha Beautillion Handbook. By affixing my signature below, I grant permission for my son to participate in the Beta Tau Lambda Charitable Foundation Beautillion Program, which is sponsored by Alpha Phi Alpha Fraternity, Inc.
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I agree
Digital Signature (Fully Typed Name)
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Today's Date
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Month
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Day
Year
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The undersigned parent/ legal guardian of the above named student hereby consents to his/her participation in activities in the Alpha Beautillion, sponsored by the Beta Tau Lambda Charitable Foundation. It is understood that the director can under reasonable and limited conditions alter the plan of monthly activity. However, such alterations shall involve activities or arrangements in the same general category described above. It is also understood that in the event the parents/ legal guardians have any questions regarding the plans or believe the description to be inadequate, he or she will contact the director to obtain additional information prior to signing this form. The undersigned does hereby consent to the above named student participating in the activity identified and agrees on his/her own behalf, and on behalf of the student named above, not to sue and hold harmless its officers, agents, servants, volunteers, the organizations, partners or any other member for any amount. Nothing herein is intended to, nor shall it be construed to release any insurance company or third party from any obligation to pay under any liability insurance or other benefit
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I agree
Digital Signature (Fully Typed Name)
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Today's Date
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Month
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Day
Year
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In the event of an emergency or medical treatment, I hereby give my consent, and/or authorize the Beta Tau Lambda Charitable Foundation, to provide medical services for my child. It is understood that this consent is given in advance of any specific diagnosis, treatment, or medical care being required and is to serve as specific consent to any and all such diagnoses, treatment or hospital care which may be deemed desirable. Medical services are approved for my child during activities, to include local corporate visits and meetings.
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I agree
Digital Signature (Fully Typed Name)
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Today's Date
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Month
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Day
Year
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Submit
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