• 2026-2027 Fairfax County Alumnae Chapter of Delta Sigma Theta Sorority, Inc.

    Delta GEMS & Delta Academy Program Application

  • The Fairfax County Alumnae Chapter of Delta Sigma Theta Sorority, Inc. Delta GEMS & Delta Academy 2026-2027 Program Application

    This application requires input from the interested Delta GEMS or Delta Academy applicant AND the applicant's parent/guardian. Please complete all portions of the application which include:

    • Applicant(s) and Guardian Information (completed by the Delta GEMS or Delta Academy participant(s) AND/OR parent/guardian)
    • Risk Management Forms (completed by the parent/guardian)
    • Parent/Guardian Consent and Emergency Information Form (completed by the parent/guardian)

    Applications must be received no later than 11:59 PM on September 27, 2026. Please send all questions to FCAC Delta GEMS Coordinator, Arianna Worthy via email GEMS@fcacdst.org or FCAC Delta Academy Coordinator, Volita Russell via email ACADEMY@fcacdst.org.

    All parents/guardians with youth participating in the 2026–2027 FCAC Delta GEMS & Delta Academy Program will be required to attend an orientation session (virtual). Orientation will be held Thursday, October 1, 2026 at 7PM EST via Zoom. After submission of the application, the application will be reviewed and a Zoom meeting invite will be sent to the email(s) noted within the application.

    Please review criteria for each program below prior to submitting an application.

    FCAC Delta GEMS Criteria:

    • Female, 14–18 years old, currently enrolled in high school (Grades 9th–12th)
    • Resides in Fairfax County
    • Has a positive attitude
    • Committed to actively participate in Delta GEMS sessions, programs, and scheduled service projects
    • Submission of application and risk management forms by the submission deadline

    FCAC Delta Academy Criteria:

    • Female, 11–14* years old (*14 and in the 8th grade)
    • Resides in Fairfax County
    • Has a positive attitude
    • Committed to actively participate in Delta Academy sessions, programs, and scheduled service projects
    • Submission of application and risk management forms by the submission deadline

  • Applicant and Guardian Information

    Please complete the following section(s) and ensure all entries are accurate for the applicant(s).
  • Grade*
  • Which program are you eligible for*
  • Are you a NEW or RETURNING applicant?*
  • Do you have a second youth applicant that you would like to include in this application?*
    • Second Applicant Information 

    • Note: In order to submit a second applicant within the same application, the youth must share at least one (1) parent or legal guardian. If the youth do not share one (1) parent or legal guardian, a seperate application must be submitted due to risk management requirements.

    • Grade*
    • Which program are you eligible for*
    • Are you a NEW or RETURNING applicant?*
    •  

    • Parent/Legal Guardian Information

      Please complete the following section and ensure all entries are accurate for the parent/guardian of applicant(s).

  • Parent/Guardian Risk Management Forms

  • In this section you will find a fillable PDF copy of the parent/guardian risk management forms titled "Appendix B All Documents - Parent Guardian Forms". Please carefully read through all appendices and complete. This is a required upload to submit the application.

    Follow the instructions:

    1. Download the blank fillable PDF and save it to your local device. You cannot edit the PDF directly in the application.
      • Note: If you do not see the download button, hover over the PDF, and then select the downward arrow icon (↓). If you are using a mobile device, you may need to open the PDF in a separate tab/browser, then download.
    2. Review and complete all appendices in the forms.
      • If you have more than one youth applicant, you may enter both names on all forms.
      • There are some appendices that may not be applicable such as driving forms. You may leave blank if not applicable.
    3. Upload the completed/signed copy of the Parent/Guardian Forms to the section below.
      • Note: This is a required upload in order to submit the application. If you experience any issues, please reach out to GEMS@FCACDST.ORG for assistance. You can also upload a placeholder/blank document and email the forms if the issue persists.
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  • Parent/Guardian Consent and Emergency Information Form

    Please provide emergency contact information for the applicant, and consent for emergency situations. This section is REQUIRED for new and returning applicants. If there are any updates throughout the duration of the 2026 – 2027 Delta GEMS/Academy program, send updates to Delta GEMS Coordinator, Arianna Worthy via email at GEMS@fcacdst.org or Delta Academy Coordinator, Volita Russell via email at Academy@fcacdst.org.

  • Accident Procedure

    In case of an accident, we will first attempt to notify the parents/guardians or the emergency contacts if the parent/guardian cannot be reached. Extreme emergencies may dictate other procedures deemed in the child’s best interest, including dialing 911 or administering first aid where necessary. Whenever a child is injured, regardless of the severity of the injury, an incident form and applicable witness statements are completed and maintained.

    I authorize the following primary and/or secondary emergency contact person to be contacted in case of an emergency:

  • Medical Conditions Does your child have a medical condition, including but not limited to allergies, that the program coordinators should be aware of before allowing your child to participate in the FCAC Delta GEMS & Delta Academy Program?*
  • I, the undersigned, having read, understood, and completed the fields above, and having been briefed regarding the nature of the Program, hereby give my permission for my child to attend and participate in the 2026 – 2027 FCAC Delta GEMS & Delta Academy Program.*
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