Distinguished Young Gentlemen of America, Inc.
National Summer Academy
Hosted on the Campus of Florida A&M University
Tallahassee, Florida
Sunday, June 10, 2012-Saturday, June 23, 2012
Application Deadline: Saturday, March 31, 2012
$10 application fee is due with submission of application. Please submit cash, money order or cashiers check made payable to DYG of America, Inc.
Mailing address: 2606 Pottsdamer St. Tallahassee, FL 32310
D.Y.G. National Summer Academy Criteria:
-Prospective Distinguished Young Gentlemen must have a minimum 3.0 cumulative grade point average. (*Note: D.Y.G. Program Staff will verify the G.P.A of all Applicants).
-Prospective Distinguished Young Gentlemen must be 9th-12th Grade African American Male Students or entering the 9th grade for the 2011-2012 academic year. Graduating seniors in the 2010-2011 academic year are not eligible for the academy.
-Prospective Distinguished Young Gentlemen must have three letters of recommendation.
-Prospective Distinguished Young Gentlemen must write a full one page typed essay detailing their personal background and relevant life experiences.
-Prospective Distinguished Young Gentlemen must submit an official high school transcript with application.
-Prospective Distinguished Young Gentlemen must submit a photo with application.
D.Y.G. National Summer Academy Location
Founded on October 3, 1887, Florida A&M University (FAMU) is part of the State University System of Florida and is fully accredited by the Southern Association of Colleges and Schools.
Distinguished by lush foliage and massive oaks, FAMU's main campus comprises 156 buildings spread over 422 acres atop the highest of Tallahassee’s seven hills.
Florida A&M University enrolls nearly 12,000 students from the United States and more than 70 countries such as India, Egypt, Trinidad, Netherlands, China, Bahamas, Jamaica, and Brazil.
Florida A&M University offers 62 bachelor’s degrees and 39 master’s degrees. The university has 13 schools and colleges and one institute. The university also offers a juris doctor at its College of Law in Orlando. FAMU has 11 doctoral programs which includes 10 Ph.D. programs: chemical engineering; civil engineering; electrical engineering; mechanical engineering; industrial engineering; biomedical engineering; physics; pharmaceutical sciences; educational leadership; and environmental sciences.
D.Y.G. National Summer Academy Housing/Dinning Services
The mission of FAMU Housing is to promote a safe, clean, service-oriented, efficiently managed, nurturing living learning environment that is conducive to students’ academic pursuits and personal growth while fostering a sense of community, civic responsibility, and an appreciation of diversity.
University Housing provides students an opportunity to experience community living and social relationships that will enhance their productivity in the world beyond the campus. Through on campus living, the University strives to provide an atmosphere where students may learn and effectively pursue their academic and personal goals.
FAMU Dining firmly believes that today’s hard working college students should be rewarded with a dining service that makes eating on campus palate-pleasing, healthy and entertaining. We hope to enrich your dining experience by making it eventful and enjoyable. Our quality, variety, nutrition and monthly promotions make our program dynamic. D.Y.G. Summer Academy participants will be served breakfast, lunch, and dinner.
D.Y.G. National Summer Academy Curriculum Objectives
The Academy is a competitive two week accelerated program for talented African American Male Students. D.Y.G. National Summer Academy Accelerated Curriculum will accomplish the following:
-Develop and implement strategies to provide effective leadership on critical issues facing our local communities.
-Create a hub and networking outlet for talented Black Male Students.
-Function as an accelerated training ground that develops and prepares the next generation of local, state, and national leaders.
-Teach relevant tangible life skills. (Oratorical, Culinary, Mechanical, Technical, and Etiquette Skills).
-Develop and cultivate the entrepreneurial spirit.
-Enhance social, professional development, and life skills.
-Teach financial literacy and wealth building strategies.
-Expose participants to high quality cultural, academic, and community oriented activities.
-Empower students through the teaching of Advanced African Studies, Communal Values, and Foreign Affairs.
-Broaden the intellectual capacities of all participants through reading and analyzing relevant essays, poems, and books.
D.Y.G. National Summer Academy AcceleratedCurriculum Modules
- Leadership & Communication
- Professional & Personal Development
- Advanced African Studies & Communal Values
- Financial Literacy & Entrepreneurship
- Foreign Affairs& Globalization
D.Y.G. National Summer Academy Fee
D.Y.G. National Summer Academy Fee of $ 250.00 will cover the following:
-Housing/Dining Services at Florida A&M University
-Florida A&M University Identification Card
-Brotherhood Activities (i.e. Bowling Night, Movie Night, Video Game Tournament, Athlete Competitions).
-Program Materials and Apparel
-Curriculum Materials
-Instructional Cost
-Insurance Coverage
*Note: The D.Y.G. National Summer Academy cost is significantly supplemented by the D.Y.G. of America Foundation and Florida A&M University. The $250.00 fee is due upon acceptance into the Academy. Please do not send the $250.00 fee with the application.
Distinguished Young Gentlemen of America, Inc.
National Summer Academy 2012 Application
Please Print in ink or Type
General Information
First Name: Middle Name: Last Name:
Address: Email:
______
City: State: Zip:
______
Primary Telephone: ( ) Secondary Telephone: ( )
Grade Level: GPA: Age: Date of Birth:
______
School Attending:
______
Applicant Signature
If accepted, I agree to fully participate and commit to the Distinguished Young Gentlemen of America Inc., 2012 National Summer Academy.
Signature of Applicant (in ink) ______Date: ______
Parent/Guardian Consent Form
Student Name: ______
Parent/Guardian Name: ______
Address: ______
City: ______FL Zip: ______
Daytime Telephone: ______Cell Phone: ______
I, the parent or guardian of the above-named child, hereby register him for participation in the Distinguished Young Gentlemen of America, Inc. National Summer Academy and do hereby release Distinguished Young Gentlemen of America, Inc. and its program staff from any liability. I, the parent or guardian, releases Distinguished Young Gentlemen of America, Inc. from all responsibilities from injuries of any nature incurred while participating in the program. I understand that my child will be supervised by a professional at all times, and that medical insurance is my responsibility.
Emergency Medical Treatment
In the event ______(student’s name) becomes ill or sustains an injury while in the care of or under the supervision of the program staff, they are given permission to administer first aid for his/her relief. In case of emergency, permission is given to take my child to the nearest appropriate emergency or clinic facility.
Family Doctor: ______Phone: ______
Address: ______City: ______Zip: ______
Allergies (if any): Name(s) of any medication currently taken:
______
In case parent/guardian cannot be reached in an emergency, please contact:
Name: ______Relationship: ______Phone Number: ______
I HAVE READ, UNDERSTOOD, AND AGREED TO ALL OF THE ABOVE.
______
Name of parent/guardian (Please print) Date
______
Parent/Guardian’s Signature
Photograph Release Form
This agreement is made between Distinguished Young Gentlemen of America, Inc. with offices at 2606 Pottsdamer Street Tallahassee, Florida 32310.
______
Please print participant/child’s name above
I hereby grant permission for Distinguished Young Gentlemen of America, Inc. to use photographs for use in any and all media and methods of transmission and/or distribution now or hereafter known, including but not limited to film, print, video, computer, Worldwide Web, Internet Website, Email, FTP, computer network, and digital reproduction and distribution, for illustration, art promotion, advertising, trade, sales, or any other purpose whatsoever.
I hereby waive any right to inspect or approve the photographs or electronic matter that
may be used in conjunction with them now or in the future, whether that use is known to
organization or unknown, including but not limited to any re-use, distortion, blurring,
alteration, optical illusion or use in composite form, either intentionally or otherwise, that
may occur in relation to the finished product.
I hereby agree to hold harmless Distinguished Young Gentlemen of America, Inc. from and against any claims, and waive any right to royalties or other compensation arising from or related to the use of the photographs.
PERMISSION GRANTED FOR THE USE REQUESTED ABOVE:
______
Parent/Guardian’s Signature
______
Name
______
Date
Authorization to Release School Records
PARENT/GUARDIAN CONSENT
Please print
Student Name: ______
Date of Birth: ______
I, the parent or guardian of the above-named student, hereby authorizes
______Student School’s Name
to release information from my child’s scholastic record, which also includes any transcripts, class schedules, attendance records, scores for standardized achievement, diagnostic test/ assessments, special education records to Distinguished Young Gentlemen of America, Inc. I hereby grant permission for Distinguished Young Gentlemen of America, Inc. to use these records for only internal use during the aforementioned program. Use of information will only be used for assessing student need, statistical purposes and program evaluation. This information will be kept confidential.
I HAVE READ, UNDERSTOOD, AND AGREED TO ALL OF THE ABOVE.
Parent/Guardian’s Name: ______
(Please print)
Parent/Guardian’s Signature: ______
Primary Phone: ______Date: ______