Alpha Men & Divas of Tomorrow Membership Application | Alpha Phi Alpha Fraternity, Inc

Personal Information

Last Name *

First Name *

Middle Initial

Address

Street *

City *

State *

ZIP *

Contact Information

Home Phone *

(XXX)XXX-XXXX

Cell Phone *

(XXX)XXX-XXXX

Birthday *

Month

Day

Year

Age *

Email Address *

Emergency Contacts

Primary Contact

Name *

Relationship *

Occupation *

Place of Employment *

Home Phone *

(XXX)XXX-XXXX

Work Phone *

(XXX)XXX-XXXX

Secondary Contact

Name *

Relationship *

Occupation *

Place of Employment *

Home Phone *

Work Phone *

(XXX)XXX-XXXX

Education Information

School Name *

Grade *

School Address

Street *

City *

State *

ZIP *

School Phone *

(XXX)XXX-XXXX

GPA (based on a 4.0 scale) *

Higher Education Aspiration

List Colleges/Universities/Technical Schools you are interested in attending. *

What are your career aspirations? *

Honors & Community Involvement

List Honors, Awards, and Outstanding Achievements you have received. *

List community organizations and school activities (athletics, student government, volunteer work) you are involved with. *

Personal Profile

List your hobbies and interests. *

What do you expect to gain from this organization? *

Why are you interested in participating in the Alpha Men & Divas of Tomorrow Youth Organization? *

Have you ever been convicted of a felony or misdemeanor? If yes, explain. Give date, offense, place, and ruling. *

Photo Release

By checking this box, I give permission to Alpha Phi Alpha Fraternity, Inc. and the Alpha Men & Divas of Tomorrow Youth Organization to use or release any photos of my child taken for the purpose of promoting the Fraternity and its youth organization. *

By checking this box, I give permission to Alpha Phi Alpha Fraternity, Inc. and the Alpha Men & Divas of Tomorrow Youth Organization to use or release any photos of my child taken for the purpose of promoting the Fraternity and its youth organization.

Date of Signature *

Month

Day

Year

Documents

Applicant Acknowledgement

By checking this box, I wish to participate in the Alpha Phi Alpha Men and Divas of Tomorrow Youth Organization. I promise to be careful to prevent damage to any buildings and harm to others that may come about while participating in activities within th *

By checking this box, I wish to participate in the Alpha Phi Alpha Men and Divas of Tomorrow Youth Organization. I promise to be careful to prevent damage to any buildings and harm to others that may come about while participating in activities within the organization. I also agree to obey the rules of the Alpha Men and Divas of Tomorrow Youth Organization, and I understand that at any time I can be expelled from the Alpha Men and Divas of Tomorrow Youth Organization for conduct that is detrimental to the program.

Date of Signature *

Month

Day

Year

Parental Consent

I hereby give my permission for my child to participate in the Alpha Men and Divas of Tomorrow Youth Organization. I understand that the participants are free to leave the program at any time. I agree to immediately update this application when any of t *

Date of Signature *

Applicant Consent

I hereby represent that each answer to the questions herein and all other information otherwise furnished is true and correct. I further represent that such answers and information constitute a full and complete disclosure of my knowledge with respect to *

Date of Signature *