Application-Debutante Cotillion Season

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Application-Debutante Cotillion Season 2016-2017 The DC Pearls III Foundation, Inc., in conjunction with, Alpha Kappa Alpha Sorority, Incorporated, Rho Mu Omega Chapter appreciates your interest in our 2016-2017 Pearl Ball Debutante Cotillion Program. Historically, a cotillion was characterized as an elaborate, formal dance. In recent years, it is most often recognized as a formal presentation of young ladies referred to as debutantes. These young ladies are presented to society after they have developed a sense of poise, grace, social etiquette skills and acquired a sense of responsibility and achievement that prepares them to master life s challenges as a lady. DC Pearls III Foundation, Inc. and Alpha Kappa Alpha Sorority, Incorporated, Rho Mu Omega Chapter have embraced this concept as an opportunity to introduce young women to society through cultural experiences. This process offers a range of social, personal, career and educational enrichment opportunities for young women. Activities consist of personal development workshops, community service projects or opportunities, etiquette training and more! Selected participants learn how to successfully transition into the next stage of their high school career before taking their bow and being presented to society at the Debutante Cotillion Ball. Participation in this program is by invitation. Please submit the non-refundable application fee of $35, completed application, sealed transcripts, two letters of recommendation, typed essay, and photo permission release form. Check or money orders should be made payable to D.C. Pearls III Foundation, Inc. Please mail complete application packages to: 2016-2017 Debutante Cotillion Selection Committee Application DEADLINE: April 15, 2016 Applications must be mailed to: DC Pearls III Foundation Attn: Pearl Ball Debutante Cotillion Selection Committee P.O. Box 91436 Washington, DC 20090-1436

How Will I Be Evaluated? Applications will be judged on the following criteria: (1) Scholastic Achievement/GPA 2.5 (2) Strong Ethical Standards (3) Extracurricular Activities (4) Community Service Activities (5) Statement of Interest (Essay) (6) Completeness and overall appearance of application Application Checklist All applications must be completed in their entirety to be reviewed and considered. Applications must be typed. Before submitting your application, please be sure that the following items in the checklist below are enclosed. One (1) Original COMPLETED application package One (1) Official Transcript (seal of the school, and in a sealed envelope) Required Typed Statement of Interest (Essay) Two (2) Sealed Letters of Recommendations (sealed in an envelope) Application Fee (Cashier s Check or Money Order) Image Release Form DC Pearls III Foundation, Inc. and Rho Mu Omega Chapter reserve the right to eliminate any incomplete, unsigned, late or illegible application from consideration.

Prospective Debutante Application Candidate Information Name: Date of Birth: Address: _ City: _ State: Zip: Telephone: (H) _ (Mobile) Participant s Email: (An active email address is required) Parent/Guardian Information Parent(s)/Guardian(s) Name Address: City State _ Zip Code _ Telephone: (H) _ (Cell) (W) _ Parent(s)/Guardian Email Address: Parent(s)/Guardian(s) Name Address: _ City State Zip Code Telephone: (H) _ (Cell) _ (W) Parent(s)/Guardian(s) Email Address: _

Academic Profile High School Grade GPA Prospective Colleges Intended Major/Concentration Special Accommodations If selected, do you have any special needs that we need to be aware of? Yes No If yes, please describe. Extracurricular Activities Activities (includes clubs and sports) Honors/Awards/Achievements Special Talents/Hobbies/Interests

Community Involvement Community Service/Civic/Volunteer Activities (Please list and include years of participation.)* Religious-based Activities* * Please use an additional sheet of paper, if necessary. Employment Are you currently employed? Yes No If yes, how many days/hours a week do you work? Additional Information Are any members of your family members of Alpha Kappa Alpha Sorority, Incorporated? _ Yes _No If yes, please include name and relationship. Emergency Contact Name Relationship Contact Number

Statement of Interest Please provide a typed essay discussing what it means to you to be a debutante, why you would be an asset to the program and your future career goals. Your statement should be between 200 and 300 words. If you provide this statement on a separate document, please include your name and email address at the top of your statement.

Acknowledgements and Signatures Candidate My signature below confirms that I have provided truthful and complete information in this application and that I understand that I may be contacted if there are questions or concerns about my application package. Candidate s Signature: _ Date: Parent/Guardian If selected, I give my daughter permission to participate in the 2016-2017 Pearl Ball Debutante Cotillion Program. I understand that it will be my financial responsibility to provide the fees necessary to cover the cost of my daughter s participation and meet all deadlines in order to meet proper inclusion in all debutante materials. This includes a non-refundable $35 application fee and a non-refundable activity fee of $550. I further acknowledge that my daughter will only be eligible for a scholarship award if she meets the minimum $2,500 minimum fundraising commitment, which is in addition to the fees referenced above. Parent/Guardian s Name (Printed): Date: Parent/Guardian s Signature: Date:

Participation Certification Form DC Pearls III Foundation and Alpha Kappa Alpha Sorority Incorporated, Rho Mu Omega Chapter (hereinafter, Sponsors) retain the right to exercise exclusive control, regarding the participation of any applicant in the 2016-2017 Debutante Cotillion Program by declining an applicant s participation, withdrawing the privilege of participation, or by further declining any participant s continued participation in the Cotillion Season, including the culminating event, the Pearl Ball. By signing this form, the candidate certifies and affirms the truthfulness of each of the following statements. To the extent the candidate is unable to certify to each of the following statements, the candidate may submit an explanatory statement that will be reviewed by the Sponsors while considering the candidate s application. I am neither married, nor have I ever been married, nor will I become married prior to the date of the Pearl Ball, the culminating event of the 2016-17 Cotillion Season. I am not currently pregnant nor have given birth to a child. I also will not become pregnant prior to the date of the Pearl Ball, the culminating event of the 2016-2017 Cotillion Season. Should I become pregnant, I understand that Sponsors, in their sole discretion, may withdraw my privilege to participate in any remaining activities of the 2016-2017 Debutante Cotillion Season. I have not been convicted of a criminal violation (other than traffic violations) nor have I ever been the subject of any other violation of a rule or policy that reflects poor moral character. Further, I have not been arrested. I will not use illegal drugs or alcohol while participating in the 2016-2017 Debutante Cotillion Season. I am neither the subject of a pending suspension or expulsion, nor have I ever been suspended or expelled from any school for any reason. In the event of a change of circumstance after the date of this certification regarding any matter contained herein, I will immediately notify the 2016-2017 Debutante Cotillion Chairmen of the details of any such matter, with the full understanding that the Sponsors retain the exclusive rights, at any time, to decline my participation for failure to adhere to all participation criteria. _ (Applicant Signature) (Applicant s Printed Name) (Date) (Parent/Guardian s Signature) (Parent/Guardian s Printed Name) _ (Date)

Image Release Form I grant to DC Pearls III Foundation, Inc., and Alpha Kappa Alpha Sorority, Incorporated, Rho Mu Omega Chapter, their representatives and members (hereinafter Sponsors ) the right to take photographs, videos, or other visual media of me and my property in connection with the 2016-2017 Debutante Cotillion Season 2016-2017, including the culminating event, The Pearl Ball. I authorize Sponsors, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Sponsors may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above. Signature Printed name Organization Name (if applicable) Address Date Signature, Parent/Guardian (if under age 18)