OCAC(CA) Youth Programs Interest Form

A mandatory orientation session is required.

Please choose a selection from the list below.

Program Details

Duration: October 2024 - June 2025	Date: 4th Saturday of each month
Location: TBA	Time: 10 AM - 2 PM
Youth Served: Girls aged 11 - 18
Dr. Betty Shabazz Delta Academy	Middle School Girls
Delta GEMS	High School Girls

Please complete the form for all children you are interested in enrolling in Orange County Alumnae Chapter (CA) Youth Programs. Interested youth must reside in Orange County.

Orientation Attendance
Please select an orientation date:

My child(ren) and I will attend Orientation on October 16, 2024 - 7pm (Zoom)My child(ren) and I will attend Orientation on October 26, 2024 - 9:30am (In-person, prior to Academy/GEMS programming)I am interested in enrolling my child(ren), but cannot attend either session. Please contact me to schedule orientation. I understand that my child(ren) will not be able to start programming on October 26.

Parent Information
Parent Name*

First NameLast Name
Phone Number*
Parent Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you interested in serving as a parent volunteer? Volunteers must attend volunteer training and complete a background check.

YesNo
How many children do you want to enroll?*

Submit Form
All youth and parents are required to attend an orientation session. Registration packets will be provided upon the completion of the orientation session.
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All youth and parents are required to attend an orientation session. Registration packets will be provided upon the completion of the orientation session.