Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc by hR2mHk

VIEWS: 10 PAGES: 9

									                                         The Debutante Process

The Arlington Foundation for Excellence in Education, formally the Xi Theta Omega Foundation, in
conjunction with the Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc. appreciates your interest in
the 2012 Debutante Scholarship Program.

The process offers a range of social, personal, career and educational enrichment opportunities for young
ladies. Activities consist of workshops, community service, etiquette training and more! Selected participants
learn to successfully transition into the next stage of their high school and college career before taking their bow
and being presented to society at the Ball.


                               How To Get Additional Information

Attend one of two informational sessions where Foundation members will answer your questions about the
program, registration procedures, training workshops and community service activities.

No registration necessary.

Sessions are held at:

DFW Airport Marriott South
4151 Centreport Blvd
Fort Worth, TX 76155

Session 1: Saturday, March 3, 2012 – 3pm
Session 2: Saturday, April 14, 2012 – 3pm

For additional information or to R.S.V.P.contact:
Carisma Ramsey at scholarships@arlingtoneducation.org




                                                                                                                  1
                          Debutante Participation Criteria

 Must be a high school senior of the class of 2013
 Must have a 2.5 cumulative grade point average (Transcript or letter from counselor is acceptable)
 Must submit two letters of recommendation from individuals outside the family (High School
  Counselor, Church, or Civic Organization, etc.)
 Submit a completed Debutante application and biography
 Must not be or become a mother during the debutante process
 Must submit photo and liability release signed by parent or guardian
 Must pay the non-refundable participation fee
 Must turn in a minimum of $1,500 in combined advertisements/patrons and/or tickets sales in order to
  be presented


    EXTENDED POSTMARKED LATE APPLICATION DEADLINE: FRIDAY, MAY 18, 2012

Items to submit:
     o Completed Debutante Application and Biography
     o Two letters of recommendation
     o Proof of grade point average – Transcript or letter from counselor
     o Photo and liability release signed by parent or guardian

                 Foundation will contact potential debutantes for interviews May 21th – 24th.
                               Interviews will be held on Saturday, May 26th

                                Applications must be mailed to:
                      The Arlington Foundation for Excellence in Education
                              Attn: Debutante Scholarship Program
                                        P.O. Box 150301
                                     Arlington, Texas 76015




                                                                                                    2
                      Debutante Participation Requirements

Participants must submit the following items at the Debutante Registration:


 Late Debutante Registration - 10am
 May 26, 2012
 DFW Airport Marriott South
 4151 Centreport Blvd
 Fort Worth, TX 76155
    o $600 Participation Fee

   Participants are required to attend training seminars, meetings, and dance rehearsals.
   To be considered for a Book Award, Debutantes must turn in a minimum of $2,000.00 in combined
    advertisements/patrons/ticket sales.
   Competition begins May 26, 2012, and ends November 14, 2012
   Scholarship Ball and Debutante Presentation is Saturday, November 17, 2012




                                                                                               3
                         The Arlington Foundation for Excellence in Education
          In conjunction with the Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc.

                                         2012 Debutante Application

Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

City, State: _________________________________________ Zip Code: _______________________

Debutante’s Phone: ___________________________________________________________________

High School: _________________________________________________________________________

Classification: ________________________________________Cum GPA:______________________

Email: ______________________________________________________________________________

Is your personal likeness depicted on the Internet or a social media page(s)? If so, please describe:

____________________________________________________________________________________

Do you have a part-time job? If so, list your work schedule below: ___________________________

_____________________________________________________________________________________

Mother’s Name: ______________________________________________________________________

Father’s Name:_______________________________________________________________________

Parent’s Phone: ______________________________________________________________________

Work Telephone: _____________________________________________________________________

Email: ______________________________________________________________________________

I certify to the best of my knowledge that the information provided on this application is true.

             _________________________________________                      ________________________
                (Signature of Applicant)                                       (Date)

    ____________________________________________                   __________________________
           (Signature of Parent/Guardian)                                     (Date)



                                                                                                        4
                                2012 Biography Form
                                     Please print or type

DEBUTANTE INFORMATION

Full Name:__________________________________________________________________________

Parent(s) Name (first and last): ____________________________________________________________

High School:_________________________________________________________________________

Grade Point Average:__________________________

Honors and Awards Received:
   1)
   2)
   3)
   4)
   5)

School Activities:
   1)
   2)
   3)
   4)
   5)

Hobbies:
   1)
   2)
   3)
   4)
   5)

Community Service:
  1)
  2)
  3)
  4)
  5)



                                                                                            5
Name of Church or Religious
Organization:_____________________________________________________________

List Church or Religious Organization Activities:
    1)
    2)
    3)
    4)
    5)

College Attending:____________________________________________________________________

____________________________________________________________________________________


Anticipated Major:____________________________________________________________________


Career Aspirations:____________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Role Model(s): ______________________________________________________________________

__________________________________________________________________________________

ESCORT INFORMATION

Escort’s Name:______________________________________________________________________

Parent(s) Name:_____________________________________________________________________

__________________________________________________________________________________

Address:___________________________________________________________________________

__________________________________________________________________________________

Escort’s Phone:_______________________ Parent’s Phone:_________________________________

Email:____________________________________________________________________________


School:___________________________________________________________________________

Significant Extra Curricular Activities: __________________________________________________

_________________________________________________________________________________
                                                                                              6
           CONSENT TO PARTICIPATE AND LIABILITY RELEASE

I, ___________________________________ (parent/guardian name), for myself and on behalf of my child,

___________________________________ (debutante name), hereby agree to and accept the
requirements and criteria outlined in the 2012 Debutante process, and hereby give permission for my child, to
participate in the 2012 Debutante Program and the 2012 Scholarship Ball and Debutante Presentation (the
“Event”) sponsored by The Arlington Foundation for Excellence in Education in conjunction with the Xi Theta
Omega Chapter of Alpha Kappa Alpha Sorority, Inc., (collectively the “Sponsors”). I hereby irrevocably and
unconditionally release, discharge, and waive any and all claims or causes of action of any nature now or
hereafter existing, whether known or unknown against the Sponsors, their agents, employees, officers,
members, volunteers, or representatives from any and all responsibility for any injuries or damage sustained by
myself or my child arising from any act or omission, negligent or otherwise, of the Sponsors, their agents,
employees, officers, members, volunteers or representatives or in connection with the Event.




Signed: _______________________________                           Date: _________________
          (Parent/Guardian Signature)




                                                                                                             7
                                        PHOTO RELEASE

I, ___________________________ (printed name), am the parent or legal guardian of the minor indicated
herein. By affixing my signature below, I hereby grant permission to the Arlington Foundation for Excellence in
Education and the Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc., to use the name and likeness
of my daughter, __________________________ (hereinafter “minor”), for any and all of its publications,
including website entries, without payment or any other consideration.

I hereby irrevocably authorize the Arlington Foundation for Excellence in Education and the Xi Theta Omega
Chapter of Alpha Kappa Alpha Sorority, Inc., to edit, alter, copy, exhibit, publish or distribute publications
featuring the name and likeness of the minor for purposes of publicizing the Arlington Foundation for
Excellence in Education and the Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc., programs and
scholarships, or for any other lawful purpose. Arlington Foundation for Excellence in Education or the Xi
Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc., shall not use the name and/or likeness of the minor
in any derogatory or demeaning manner. In addition, I hereby waive the right to inspect or approve the finished
product, including written or electronic copy, wherein such likeness of the minor appears. Additionally, I waive
any right to royalties or other compensation arising or related to the use of the name and/or likeness of the
minor.

Further, I hereby hold harmless and release and forever discharge the Arlington Foundation for Excellence in
Education and the Xi Theta Omega Chapter of Alpha Kappa Alpha Sorority, Inc from any and all
claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other
persons acting on my behalf, on behalf of my estate, or on behalf of the minor, have or may have by reason of
this authorization.

By my signature below, I acknowledge that I have read this release and fully understand the contents, meaning,
and impact of this release. A fully executed faxed or scanned copy of this release shall be acceptable.



____________________________                 ___________________
Signature of Parent/Guardian                       Date




                                                                                                               8
Contacts:
Carisma Ramsey
Scholarship Chairman
Scholarships@arlingtoneducation.org or carismadr@yahoo.com
(225) 931-7310

Gina Brown
Scholarship Co-Chairman
Scholarships@arlingtoneducation.org or slpgb@yahoo.com
(817)-266-2622

The Arlington Foundation for Excellence in Education Scholarship Website
www.arlingtoneducation.org

Xi Theta Omega Website
www.xithetaomega.com




                                                                           9

								
To top