Baltimore Metropolitan Alumnae Chapter

Baltimore Metropolitan Alumnae Chapter

Delta Sigma Theta Sorority, Inc.

YOUTH PROGRAMS

2015-2016

Thank you for your interest in the Youth Programs of the Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority, Inc.

We are proud to sponsor two youth programs for females, the Dr. Betty Shabazz Delta Academy (ages 11-14) and the Dr. Jeanne L. Noble Delta GEMS Program (ages 14-18) and one program for males, EMBODI (ages 11-18).

Included in this packet is information about all of the programs, the application that should be completed by the parent and youth participant, and other needed forms. All forms should be returned by mail to the Coordinators for the program of interest to the address listed below:

BMAC-DST

P.O. Box 992

Baltimore, Maryland 21203

Attn: Youth Programs

Ms Joe Ann Oatis

Delta Sigma Theta Sorority, Inc. History

Delta Sigma Theta Sorority, Inc. was founded on January 13, 1913 by twenty-two

collegiate women at Howard University. These students wanted to use their collective strength to promote academic excellence and to provide assistance to persons in need. The first public act performed by the Delta Founders involved their participation in the

Women's Suffrage March in Washington D.C., March 1913. Delta Sigma Theta was incorporated in 1930.

The Sorority is a private, non-profit organization whose purpose is to provide assistance and support through established programs in local communities throughout the world. A

sisterhood of more than 250,000 predominately Black college educated women, the

Sorority currently has over 900 chapters located in the United States, England, Japan (Tokyo and Okinawa), Germany, the Virgin Islands, Bermuda, the Bahamas and the

Republic of Korea. The major programs of the sorority are based upon the

organization's Five Point Programmatic Thrust: Economic Development, Educational Development, International Awareness and Involvement, Physical and Mental Health

and Political Awareness and Involvement

The Sorority was founded in 1913 by 22 students at Howard University. These young

women wanted to use their collective strength to promote academic excellence; to provide scholarships; to provide support to the underserved; educate and stimulate

participation in the establishment of positive public policy; and to highlight issues and provide solutions for problems in their communities.

Delta Sigma Theta Sorority, Inc. conducts all of its activities in accordance with the rules that govern organizations whose tax status is 501(c)(7).

Baltimore Metropolitan Alumnae Chapter History

The Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority, Inc. was chartered on March 1, 1987 by 36 illustrious women who continue to support public service activities of our sorority nationally, regionally and locally.

As members of the largest public service sorority, the Sorors of BMAC have worked

diligently in many social and political activities. We remain cognizant of the many

challenges that affect African Americans and remain active and vocal in efforts to uplift Baltimore and other regions of the global African American Community.

Dr. Betty Shabazz Delta Academy

Mission Statement

Catching the Dreams of Tomorrow, Preparing Young Women For the 21st Century, The Delta Academy was created out of an urgent sense that bold action was needed to save our young females (ages 11-14) from the perils of academic failure, low self- esteem, and crippled futures. Delta Academy provides an opportunity for local Delta chapters to enrich and enhance the education that our young teens receive in public schools across the nation. Specifically, we augment their scholarship in math, science, and technology, their opportunities to provide service in the form of leadership through service learning, and their sisterhood, defined as the cultivation and maintenance of relationships. A primary goal of the program is to prepare young girls for full participation as leaders in the 21st Century.

Delta Academy has taken many forms. In some chapters, the Academies are after-school or Saturday programs; others are weekly or biweekly throughout the school year; and still other programs occur monthly. At a minimum, chapters plan and implement varied activities based upon the needs of the early adolescents in their areas. The activities implemented most often include computer training, self- esteem and etiquette workshops, field trips for science experiences and for college exposure, and special outings to cultural events, fancy dinners, museums, plays, and concerts.

BMAC Dr. Betty Shabazz Delta Academy Coordinators

Cassandra Moore Thomas

Email:

Phone: 410 530-1723

Carolyn Salley

Email:

Phone: 410 581-8089

Kim Bradley

Email:

Phone: 952-5611

Delta G.E.M.S.

(Growing and Empowering Myself Successfully)

Mission Statement

Delta Gems was created to catch the dreams of African American at-risk, adolescent girls aged 14-18. Delta GEMS provides the frame work to actualize those dreams through the performance of specific tasks that develop a CAN DO attitude. The goals for Delta GEMS are:

• To instill the need to excel academically;

• To provide tools that enable girls to sharpen and enhance their skills to

achieve high levels of academic success;

• To assist girls in proper goal setting and planning for their futures high

school and beyond; and

• To create compassionate, caring, and community minded young women by

actively involving them in service learning and community service opportunities.

The Delta GEMS framework is composed of five major components (Scholarship, Sisterhood, Show Me the Money, Service, and Infinitely Complete), forming a road map for college and career planning. Topics within the five major components are designed to provide interactive lessons and activities that provide opportunities for self- reflection and individual growth.

Delta GEMS Coordinators

Torena Brown

Email:

Phone: 443-474-7137

Brittiany Bolden

Email:

443-362-0774

EMBODI

Mission Statement

The EMBODI (Empowering Males to Build Opportunities for Developing Independence) program is designed to provide growth opportunities for and enhance the lives of males ages 11-18. The program serves as a motivational tool for African American teenage males with the ultimate goal of increasing knowledge and awareness of issues affecting young men today.

The goals of EMBODI are:

·  To expand the horizons of young African American males by cultivating a personal vision for their lives;

·  To provide tools for young African American males to attain a higher quality of life;

·  To provide young African American males with an awareness of various college and career options to make rewarding life choices and decisions; and

·  To create community-minded young African American males by actively involving them in service learning and community service opportunities.

EMBODI Coordinators

Kathie McLaughlin

Email:

Phone: 443-558-8357

Kim Lyles

Email:

Phone: 410-206-4818

Gail Mayfield

Email:

Phone: 443-857-9030

Youth Program Application

Please Check the Program of Interest

_____Dr. Betty Shabazz Academy (Ages 11-14 and Grades 6-8)

_____Dr. Jeanne L. Noble Delta G.E.M.S. (Ages 14-18, Grades 9-12)

_____EMBODI (Males Age 11-18, Grades (6-12)

Youth’s Name: ______

Address: ______

City: ______State: ______Zip Code: ______

Home Phone No.:______

Date of Birth: ______ Age: ______

School: ______ Grade Level: ______

Youth’s E-mail Address: ______

Parent/Guardian Name: ______

Parent/Guardian Phone No. (H) ______Cell ______

Parent/Guardian Email Address:______

How did you find out about the program? ______

Why do you want to participate in the youth program of choice? ______

______

Short Essay: What do you hope to gain from participating in the program? ______

______

______

______

Student Background Information

Favorite School Subjects:

______

______

List all extracurricular activities (including community and church activities, public service projects and interests): ______

______

______

Hobbies/Talents: ______

______

What are your goals after middle/high school? ______

______

______

______

______

______

______

Youth Participant Signature/Date______

Parent/Guardian Signature/Date______

For Official Use Only: ______Recruitment Source:______

Essay Complete: ___Yes ___NO ______Returning Student: ___Yes ___No______

PARENTAL AFFIRMATION, COMMITMENT, WAIVER

AND RELEASE FORM

I, ______, Parent/Guardian, under penalty of perjury, do hereby affirm to the Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated that I authorize the participation of ______, Participant Minor Child, in the Baltimore Metropolitan Alumnae Chapter’s youth program (including planned activities), and that I have the legal authority to provide my consent and authorization for such participation.

I understand that by signing my child up to participate in the Youth Programs of the Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority Inc., I am committing to ensuring that my daughter/son will attend each monthly session so that she/he will be able to take full advantage of what the program has to offer. I also commit to arrange to have her/him dropped off and picked up on time to each session. If my daughter/son is unable to attend a session, I will inform the Coordinators in advance.

In addition I do hereby release, waive, discharge, covenant not to sue and agree to hold harmless Delta Sigma Theta Sorority, Incorporated ("Delta"), its officers, National Executive Board, employees, members, local chapters, representatives, agents, affiliates, and assigns (collectively "Releasees"), from any and all claims, demands, and actions of any and every kind directly or indirectly arising out of, or relating in any respect to Participant Minor Child's participation in the Baltimore Metropolitan Alumnae Chapter’s Youth Program.

My waiver and release of all claims, demands, actions, and liability shall include without limitation, any injury, illness, death, property damage or loss to the Participant Minor Child which may be caused by any act, or failure to act, by the Releasees, unless such injury, illness, death, property damage or loss is a direct result of the willful misconduct of any Releasee.

I understand that, without limitation of the foregoing, neither Delta, nor the Program, shall be liable and each is hereby released from all claims that may arise from loss or damage to the Participant Minor Child's personal property.

Printed Name: ______

Signature: ______

Date: ______

Relationship to child: ______

EMERGENCY CONTACT INFORMATION

Parent/Guardian #1

Name______Relationship______

Street Address______

City______State ______Zip Code ______

Home Phone______Work Phone ______Cell Phone ______

E-mail address______

Parent/Guardian #2

Name______Relationship______

Street Address______

City______State ______Zip Code ______

Home Phone______Work Phone ______Cell Phone ______

E-mail address______

If for any reason I/we cannot be reached, please contact the following person(s) below, whom I/we hereby authorize, to seek emergency medical or surgical care for my/our child in my/our absence at the closest medical facility. I/We will be responsible for any and all expenses incurred and authorize the medical facility, at which treatment is rendered, to release all necessary information to my/our insurance company.

Name: ______Relationship to Child ______

Home Phone______Work Phone ______Cell Phone ______

Name: ______Relationship to Child ______

Home Phone______Work Phone ______Cell Phone ______

Parent/Guardian Signature ______Date______

Parent/Guardian Signature ______Date ______

YOUTH PICK-UP AUTHORIZATION FORM

By signing below, I am verifying and authorizing the persons listed below to pick-up my child from the Baltimore Metropolitan Alumnae Chapters’ youth program and authorizing the Baltimore Metropolitan Alumnae Chapter to release my child to the persons listed below. For my child's safety, I understand that all authorized persons on the list below will be asked to show photo identification before my child is released to them; therefore, I will notify all authorized persons of this requirement so that they will have photo identification with them when they arrive to pick-up my child. (Also include names of parents/guardians on list below). I also agree to notify the Baltimore Metropolitan Alumnae Chapter in writing of any changes to the list of authorized persons below.

Name ______Relationship______

Home Phone______Work Phone ______Cell Phone ______

Name ______Relationship______

Home Phone______Work Phone ______Cell Phone ______

Name ______Relationship______

Home Phone______Work Phone ______Cell Phone ______

Parent/Guardian Signature ______Date______

Walking/Riding Public Transportation Authorization Form

By signing below, I am authorizing the Baltimore Metropolitan Alumnae Chapters’ Youth Programs to release my child ______to either walk/ride public transportation home at the end of the program offering. I understand that once my child leaves the premises, the Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority, will not be held liable for my child.

Parent/Guardian Signature ______Date______

General Permission Slip to Participate in Discussions on

Current Topics of Interest

I/We give our permission for our child, ______to participate in discussions and receive information from authorized adult leaders of the Baltimore Metropolitan Alumnae Chapter of Delta Sigma Theta Sorority Inc. or from representatives of outside groups whom the adult leaders of the chapter deem appropriate.

I understand that such discussions may include topics such as sexuality, drugs, and other current issues and topics.

Media Release

I/We ______give permission for

(parent/guardian's name)

my/our child ______to be photographed and videotaped and further give permission for the use of his/her likeness to be used in any publication, educational material, advertising, news media, and World Wide Web materials that Baltimore Metropolitan Alumnae Chapter (BMAC) and/or the Youth Programs may utilize and produce. I understand and agree that such materials, including all negatives, positives, digital images, and prints shall become and remain the sole property of BMAC and the Youth Programs and I shall have no right or title to such items. I further understand and agree that these materials may be kept on file and used by BMAC and/or the Youth Programs for potential future use. I further understand that these materials will not be posted on any social media sites (Face book, MySpace, Twitter). I agree to release the BMAC and/or Youth Programs from any and all liability arising from or in connection with the taking, use, publication, and/or dissemination of such materials. Copies of these photos may be distributed to the parent upon request.

******************************************************************************

Parent/Guardian Signature ______Date______

Parent/Guardian Signature ______Date ______

Sample Trip Permission Slip

(This does not need to be completed until a trip is scheduled - for your records only)

I/We, ______(“Parent/Guardian, as

parent(s) or legal guardian(s) of ______(“Child”),