2020 GMAC Leadership Program and Debutante Cotillion Application

2020 GMAC Leadership Program and Debutante Cotillion Application

Please complete ALL fields
- Full Name*
  
  First NameLast Name
- Birth Date*
  
  MonthDayYear
- Applicant's E-mail*
- Applicant's Phone Number*
  
  Area CodePhone Number
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Mother/Guardian's Name*
  
  First NameLast Name
- Mother/Guardian's E-mail*
  example@example.com
- Mother/Guardian's Phone Number*
  
  Area CodePhone Number
- Father/Guardian's Name
  
  First NameLast Name
- Father/Guardian's E-mail
  example@example.com
- Father/Guardian's Phone Number
  
  Area CodePhone Number
- Please upload your headshot. It should only be a picture of the applicant. (JPEG or JPG Format)*
  
  Browse Files
  
  Cancelof
- Please include all social media handles (FB, IG, SnapChat, Twitter)*
- High School *
- High School (City)*
- GPA (Please include your GPA and your school scale( i.e. 4.0, 100, etc)*
- 2020 - 2021 HIGH SCHOOL CLASSIFICATION. You must be a HS Junior or HS Senior at the time of the Cotillion Ball in December 2020. *
- Be sure to include name of activity, grade level of participation, accomplishments and positions held.
- School Activities (Please list all the clubs you participate in and dates involved)*
- Leadership Roles (Please indicate if you have served in a leadership capacity and dates)*
- Other Extracurricular Activities*
- If you attend Church, please indicate which one (name & city) and all the activities you participate in*
- Honors/ Awards/ Achievements*
- Special Talents and Hobbies*
- 1. What field of study and/or career are you interested in pursuing? *
- 2. Why are you interested in participating as a Debutante? *
- 3. Describe one of your family "Traditions" and why is it meaningful to you? *
- 4. What aspect of African American "Culture" are you most proud of OR which cultural icon do you most admire most and why? *
- 5. If selected to participate in our Leadership Program and Debutante Cotillion, what "Promise" do you envision making to your community, your family or yourself upon completion? *
- I understand that I must submit an official SEALED transcript from my school documenting that I have at least a 2.8 GPA (or equivalent). Without it, my application will be incomplete.
  
  It must be submitted by October 21, 2019.
- AGREED
- Prospective Debutantes will be considered for financial hardship assistance with the program entry fee on a case-by-case basis IF a financial hardship statement is submitted here that includes:
  
  ·       Reason for requesting assistance
  
  ·       Amount of support requested
  
  ·       Household composition (total number of people living with the Debutante)
  
  In addition, please provide documentation of your financial hardship. Some acceptable examples include, but are not limited to, school financial award letter, parental unemployment certification, or parental disability certification.
- Please upload your STATEMENT of financial hardship here.
  
  Browse Files
  
  Cancelof
- Please upload your DOCUMENTATION of financial hardship here.
  
  Browse Files
  
  Cancelof
- Please indicate if your mother/guardian is a member of the following chapters of Jack and Jill of America, Inc.*
- Please indicate how you learned of our Leadership Program and Debutante Cotillion*
- By signing this form I agree that all of the above statements are true and accurate.
- Applicant Signature*
  
  Clear
- Parent/Guardian Statement: If selected, I give permission for my daughter to participate in the Greater Metropolitan Atlanta Chapter’s 2020 Leadership Program and Debutante Cotillion. I understand that it will be my financial responsibility to provide the fees necessary to cover the cost of participation for my daughter and to meet all deadlines in order to ensure proper inclusions in Program materials. This includes, but is not limited to, the non-refundable application fee and non-refundable program entry fee. Also, I am aware that our inability to meet required fundraising minimums will result in my daughter being omitted from any special financial awards given to those participants who meet the program requirements.
- Parent/Guardian Signature*
  
  Clear
- Application Fee*
  
  prevnext( X )
  USD(Includes transaction fee)
  
  loading smart payment buttons...
  
  The payment is ready! It will be completed once you submit the form.
- Should be Empty: