Application Cotillion 2013 by L587rDN

VIEWS: 6 PAGES: 1

									                                           Cotillion 2013
                                      Participant Application
          Sponsored by Delta Sigma Theta Sorority, Incorporated
                 Kansas City, Missouri Alumnae Chapter
                                   and
      Delta Education and Economic Development Foundation   (DEED)

     An official high school transcript and two (2) typewritten letters of recommendation must accompany all
     applications. At least one recommendation should be from an academic official .


TO: Cotillion Committee:
I hereby recommend the following student as a candidate for participation in Cotillion 2013.
                                                                        Home Phone
               Signature of Financial Soror                             Work Phone


Participant Information:
Name: ______________________________________________ Sex: _______ Birthday: ________________
           First             Middle                 Last                                                  Month / Day / Year

Mailing Address ____________________________________________________________________________
                    Street                                       City                      ST                   Zip

Home Telephone: _____________________________ Mobile Telephone: _____________________________
                      (Area Code) Number                                                   (Area Code) Number

E-Mail: ____________________________________________________________________________________


School Name: ________________________ Year of Graduation: _______ SSN Last 4 Digits Only: _________


Parent Information:
Mother: _________________________________________________                         Telephone: ______________________
                                                                                                   (Area Code) Number

Mother’s Address ___________________________________________________________________________
                    Street                                       City                      ST                   Zip
                                           (If different from student’s mailing address)

Mother’s Email: ______________________________________                     Daytime Telephone: ___________________
                                                                                                   (Area Code) Number

Father: __________________________________________________                        Telephone: ______________________
                                                                                                   (Area Code) Number

Father’s Address ___________________________________________________________________________
                    Street                                       City                      ST                   Zip
                                           (If different from student’s mailing address)

Father’s Email: _______________________________________                     Daytime Telephone: ___________________
                                                                                                      (Area Code) Number
DEADLINE: September 15, 2012
All application packages must be postmarked or delivered by September 15, 2012. Incomplete packages will not be accepted. All
applicants and at least one parent must attend a mandatory Informational Meeting on Sunday, September 23, 2012. Refer to the
website (www.dstkcmo.org) for time and location.

                         Please mail to:        Cotillion Steering Committee, DEED FOUNDATION
                                                P.O. Box 16381
                                                Kansas City, MO 64112

								
To top