My Black is Beautiful

My Black is Beautiful Registration Form

Please complete the form to register for the workshop. If you are registering a group of 6 or more girls, upload a document listing each participant's full name, age, email, school, t-shirt size and dietary restriction if applicable. Registration will close on May 13th or when capacity has been met.
Thank you so much for your interest however, capacity has been met.
Group Registration? *

Yes No
Group Name:
Group Contact:

First Name Last Name
Contact E-mail:
Contact Number:

- Area Code Phone Number
Upload Group Form
Would you like to attend the adult sessions?

Yes No
Participant 1:

First Name Last Name
(1) Age:
(1) E-mail:
(1) School:
(1) First time attendee?

Yes No
(1) Would you like a MBIB bag?:

Yes No
(1) Dietary Restriction?

Yes No
(1) List Restrictions:
Register 2nd Participant?

Yes No
Participants 2:

First Name Last Name
(2) Age:
(2) E-mail:
(2) School:
(2) First time attendee?

Yes No
(2) Would you like a MBIB bag?:

Yes No
(2) Dietary Restriction?

Yes No
(2) List Restrictions:
Register 3rd participant?

Yes No
Participants 3:

First Name Last Name
(3) Age:
(3) E-mail:
(3) School:
(3) First time attendee?

Yes No
(3) Would you like a MBIB bag?:

Yes No
(3) Dietary Restriction?

Yes No
(3) List Restrictions:
Register 4th participant?

Yes No
Participants 4:

First Name Last Name
(4) Age:
(4) E-mail:
(4) School:
(4) First time attendee?

Yes No
(4) Would you like a MBIB bag?:

Yes No
(4) Dietary Restriction?

Yes No
(4) List Restrictions:
Register 5th participant?

Yes No
Participants 5:

First Name Last Name
(5) Age:
(5) E-mail:
(5) School:
(5) First time attendee?

Yes No
(5) Would you like a MBIB bag?:

Yes No
(5) Dietary Restriction?

Yes No
(5) List Restrictions:
Parent/Guardian:

First Name Last Name
E-mail
Phone Number

- Area Code Phone Number
My daughter(s) has participated in the past:

Delta Academy Delta GEMS Neither
Would you like information on:

Delta Academy (11-14 yrs) Delta GEMS (14-18 yrs)
How did you learn of this event?: *

I participate in Delta Academy/Delta GEMS A member of Delta Sigma Theta Sorority, Inc. Friend Social Media Community Calendar Event Flyer Church Other option
Which Chapter?: *

Evanston North Shore Alumnae Chapter Other option
Which Social Media *

Evanston North Shore Alumnae Chapter's Facebook Page Another Facebook Page Twitter Other option
Print prior to submitting your registration form. All questions should be emailed to MBIB@dstevanston.org.
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