OCAC(CA) Youth Programs Interest Form

A mandatory orientation session is required.

Please choose a selection from the list below.

Program Details

Duration: November 2025 - May 2026	Date: 3rd Saturday of each month
Location: Santa Ana College	Time: 10 AM - 2 PM
Youth Served: Girls aged 11 - 18
Dr. Betty Shabazz Delta Academy \| Middle School Girls
Delta G.E.M.S. \| High School Girls

Please complete the form for all children you are interested in enrolling in Orange County (CA) Alumnae Chapter 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 18, 2025 - 10AM (Santa Ana College. Further location details will be provided prior to Orientation)I am interested in enrolling my child(ren), but cannot attend this session. Please contact me to schedule orientation. I understand that my child(ren) will not be able to start programming in October.

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.