Kappa League Research Paper

The Tallahassee Alumni Chapter of Kappa Alpha Psi Frater nity, Inc. presents

APPLICATION PACKET
Toraino Owens, Polemarch, Tallahassee Alumni Chapter Fred Harris, Vice Polemarch, Tallahassee Alumni Chapter Kappa Alpha Psi Fraternity, Inc. Esrone McDaniels, Kappa League Advisor Clyde Lemon, Co-Kappa League Advisor Shawn Brown, Co-Kappa League Advisor Antonio Carrion, Co-Kappa League Advisor

2011 - 2012

Kappa League Membership Application
The Kappa League of Tallahassee, Florida is a mentoring program with primary purposes of developing young men to become effective leaders and assisting them with cultivating professional and social skills that will help them excel in all endeavors. This is achieved through interactive and stimulating workshops, activities and events using a leadership development module comprised of the following phases: Phase I - Self Identity Phase II - Training Phase III - Competition Phase IV - Social Phase V - Health Education The Tallahassee Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. is extremely excited about your interest in Kappa League. We certainly
hope that this experience will be one of value, service and professional and social development. Each interested person must meet the criteria below, complete the “Kappa League Membership Application” and submit, along with all of the documents and items requested, by Tuesday, January 10, 2012. Please contact Mr. Esrone McDaniels, Kappa League Advisor, at 850-284-8034 to schedule delivery of your application on or prior to that deadline or scan the document and email to [e-mail]. Eligibility Criteria and documents: √ Must be a teenage male enrolled in a High School located in Leon, Wakulla or Gadsden Counties, Florida √ Must currently have and maintain a GPA of at least a 2.0 (need official transcript or copy of recent report card) √ Must write and submit an essay on “what it means to be a leader within your community” √ Must be a teenager of good character and ambition √ Must have parent involvement with the program √ Must be able to attend scheduled meetings and events √ Must pay an application fee of $25.00 √ Must pay annual dues in the amount of $25 (if selected for membership) The application must be completed in its entirety. Incomplete applications will not be accepted. No applications will be accepted after the Tuesday, January 10, 2012 due date. Absolutely no exceptions!

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Date: ________________________ PERSONAL INFORMATION Name___________________________________________________________________ (Last) (First) (Middle) Age _______ Date of Birth ____________________ Grade ____________ Address: ____________________________________________________________________ (Street City/State/Zip) Student home Phone____________________ Student Cell Phone ___________________ Student email (required) ____________________ Parent email (required) ______________ Mother's Name ______________________ Father’s Name ________________ Guardian’s Name (if not mother or father): ____________________________________ Mother’s Employer ____________________ Father’s Employer ____________________ Mother's Job Title ____________________ Father's Job Title ______________________ Mother’s Work Phone ___________________ Father’s Work Phone_________________ Guardian’s Employer: _________________________ Work Phone: ________________ Guardian’s Job Title: __________________________ Number of Brothers_____ Sisters_____ Younger Siblings_____ Older Siblings ________ ACADEMIC INFORMATION High School Name______________________________ GPA _____________ Academic Honors: _______________________________________________________________________ List Courses enrolled in fall semester: ___________________, ___________________, ____________________ __________________, ____________________, _____________________ List Courses enrolled in spring semester: ____________________, __________________, ____________________ __________________, ____________________, _____________________ Courses enjoyed the most____________________________________________________________________ Courses enjoyed the least____________________________________________________________________ Career Choices (if Known) ________________________________________________________________________

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List 3 colleges or University you would like to attend and why (if known)? ____________________, ____________________ , ____________________ Why (if known)? ________________________________________________________________________ ______________________________________________________________________________ __________________________________________________________________ Why do you want to participate in Kappa League? ______________________________________________________________________________ __________________________________________________________________ HOBBIES & INTERESTS Band ____ (Instrument) ________________ Are you a section leader _________________ Do you currently participate in any of these school activities? If yes, which one? Choir_____ Dance_____ Football_____ Basketball_____ Baseball____ Track____ Tennis____ Other (i.e., drawing, graphic design, DJ) ________________________________________________________________________ Other Club Activities: ______________________________________________________ Community Involvement: ___________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Leadership Roles Skills____________________________________________________________________ Are you involved in Student Government? If so list your office. ________________________________________________________________________

CERTIFICATIONS Release for Medical Treatment In the event of an emergency and the inability of the Tallahassee Kappa League Advisors to obtain my consent, I hereby give permission for the Tallahassee Alumni Chapter of Kappa Alpha Psi Fraternity Inc. to authorize any medical treatment or surgery in which a qualified physician or surgeon shall deem prudent for my child. Parent/Guardian Signature: _____________________________ Date: ________ Parent/Guardian Signature: ___________________________ Date: __________ In case of an emergency, which hospital or urgent care do you prefer to have your child transported? Hospital/Urgent Care Facility: _____________________________________________ Primary Care Physician's Name: ____________________________________________

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Parental Acknowledgment I hereby give permission for my child to participate in the Tallahassee Kappa League.
I understand that the Tallahassee Alumni Chapter of Kappa Alpha Psi is not responsible for personal injury or loss of property. I understand that children are free to leave the program at anytime. I agree to immediately update this application when any information changes. Parent/Guardian Signature: ___________________________ Date : ________ Parent/Guardian Signature: ___________________________ Date: _________ Photo Release I give permission to the Tallahassee Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. to use or release any photos of my child taken for the purpose of promoting the Fraternity and its Guide Right Program. Parent/Guardian Signature: ___________________________ Date: ______ Parent/Guardian Signature: ___________________________ Date:
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Applicant Acknowledgement I wish to participate in the Tallahassee Kappa League. I promise to be careful to prevent damage to any property that may be used while participating in activities with the Tallahassee Kappa League. I also agree to obey the rules of the Tallahassee Kappa League, and understand that, if at anytime I participate in any misconduct or unethical activities, I will be suspended or expelled from participation with the Tallahassee Kappa League. Applicant signature _________________________ Date: ____________

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