Foundation for
D
elta
E
ducational and
E
conomic
D
evelopment
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Participant Profile Form
Draft Form Due: December 11, 2022
Final Form Due: January 15, 2023
Participant
First Name
Middle Name
Last Name
Suffix
(Area Code)Mobile Number
Email
Parent/Guardian
Mother
Father
Guardian
First Name
Last Name
Relationship
(Area Code)Mobile Phone
Email
Father
Mother
Guardian
First Name
Last Name
Relationship
(Area Code)Mobile Phone
Email
How should your parents’/guardians’ name appear in the Souvenir Journal? (Check One)
Mr. John and Mrs. Jane Doe
Mr. John Doe and Mrs. Jane Doe
Other
List Family Members that are past Cotillion Participants
1. First Name
Last Name
Relationship
Cotillion Year
2. First Name
Last Name
Relationship
Cotillion Year
3. First Name
Last Name
Relationship
Cotillion Year
4. First Name
Last Name
Relationship
Cotillion Year
5. First Name
Last Name
Relationship
Cotillion Year
What high school do you currently attend?
List your top 5 activities, clubs, teams, sports, honors or awards that you have received or participated in throughout high school and the number of years.
1.
Number of Years
2.
Number of Years
3.
Number of Years
4.
Number of Years
5.
Number of Years
List your top 5 church activities, involvement, ministries, etc. that you have participated in and the number of years you were involved.
1.
Number of Years
2.
Number of Years
3.
Number of Years
4.
Number of Years
5.
Number of Years
List your top 5 community service activities and the number of years you have been involved.
1.
Number of Years
2.
Number of Years
3.
Number of Years
4.
Number of Years
5.
Number of Years
What church do you currently attend?
Type a formal paragraph about your goals, include the college you plan to attend, your major(s) and your future career.
Type a formal paragraph about your most Memorable Moment (Positive) and explain why it was so memorable. Include what you learned from it.
What is your favorite quote or motto that you chose to live by? Include the author, if applicable.
Spam protection question: what is four plus one?