Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 College Tour Agenda WEDNESDAY, SEPTEMBER 4, 2013 * denotes cost included in registration fee $ denotes student is responsible for the $9 cost Departure from WESTMINSTER BETHANY PRESBYTERIAN CHURCH
7:00PM
3:00AM 7:00 AM 8:00AM 9:00 AM 10:30AM 10:45AM 12:30 PM 1:30PM 2:30 PM 4:30 PM
Breakfast *
Lunch *
Dinner ($)
5:30PM 6:00PM 6:45 PM 10:00PM Dinner *
6:30AM 7:00AM 9:00AM 11:00 AM 2:30 PM 4:00 PM 5:00PM 5:30PM 6:00PM 8:30PM 10:15PM 10:30 PM
Breakfast *
Snack Lunch *
Dinner *
THURSDAY, SEPTEMBER 5, 2013 * denotes cost included in registration fee $ denotes student is responsible for the $9 cost Arrive BAYMONT INN & SUITES BAYMONT INN & SUITES Depart BAYMONT INN & SUITES Arrive at DUKE UNIVERSITY Depart from DUKE UNIVERSITY Arrive at NORTH CAROLINA CENTRAL UNIVERSITY NORTH CAROLINA CENTRAL UNIVERSITY Depart NORTH CAROLINA CENTRAL UNIVERSITY Arrive at NORTH CAROLINA A&T STATE UNIVERSITY NORTH CAROLINA A&T STATE UNIVERSITY Cost of Lunch - $9 Depart NORTH CAROLINA A&T STATE UNIVERSITY Arrive at BENNETT COLLEGE Depart BENNETT COLLEGE Arrive HOLIDAY INN EXPRESS HOTELS & SUITES EMPORIA PIZZA PARTY at BAYMONT INN SUITES
FRIDAY, SEPTEMBER 6, 2013 * denotes cost included in registration fee $ denotes student is responsible for the $9 cost HOLIDAY INN EXPRESS HOTELS & SUITES EMPORIA Depart from HOLIDAY INN EXPRESS HOTELS & SUITES EMPORIA Arrive at HAMPTON UNIVERSITY Depart HAMPTON UNIVERSITY Arrive at GEORGE MASON UNIVERSITY GEORGE MASON UNIVERSITY Depart GEORGE MASON UNIVERSITY Arrive at MARTIN LUTHER KING MEMORIAL Depart MARTIN LUTHER KING MEMORIAL Arrive TGIF RESTAURANT Depart TGIF RESTAURANT Arrive at INN AT WILMINGTON
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 College Tour Agenda
6:00AM 7:30AM 8:30AM 11:30 AM 1:00PM 6:00PM 8:30PM
Breakfast * Snack ($) Lunch ($)
SATURDAY, SEPTEMBER 7, 2013 * denotes cost included in registration fee $ denotes student is responsible for the cost INN AT WILMINGTON Depart from INN AT WILMINGTON Arrive at UNIVERSITY OF PENNSLYVANIA Depart UNIVERSITY OF PENNSLYVANIA Arrive DORNEY PARK Depart from DORNEY PARK Arrive at WESTMINSTER BETHANY PRESBYTERIAN CHURCH
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 Registration & Consent Form Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter, Archonette Club College Tour is an educational activity designed to give high school students the opportunity to explore higher learning at select colleges and universities. The tour is a four-day trip, where students have the opportunity to visit college/university campuses, tour their facilities and interact with administrators and currently enrolled students. The tour is open to NYC female students who are in the 9th –12th grades only. Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter reserves the right to deny any application. Important dates Online Payment (to reserve your seat) – August 17, 2013 Completed Application and Required Forms/Documents – August 30, 2013 Cost The cost of the tour is $295 per student. NOTE: The amount actually paid may differ depending of method of Paypal payment used – see below. The cost includes round-trip transportation, hotel accommodations, trip to Dorney Park and some meals. Payment of your registration fee and submission of a completed College Tour application, copy of the insurance card and an official copy of the student’s last report card by the stated deadlines are required to guarantee your seat on this tour. Space reservation will be done on a first come first serve basis; however your seat will not be confirmed unless we timely receive the aforementioned items. Acceptable Forms of Payment Payment must be submitted via Paypal on or before August 17, 2013 - see below for payment instructions NO PERSONAL CHECKS WILL BE ACCEPTED – NO EXCEPTIONS!!!
Transportation, Hotel Accommodations and Meals Every PAID student and authorized chaperone will receive round-trip transportation, 1 admission ticket to Dorney Park, three nights of hotel accommodations, and some meals (see attached Trip Itinerary for specific included meals) Spending Money Students will have the opportunity to purchase snacks and souvenirs from the college/university bookstores. We advise bringing no more than $150 to cover both types of purchases. Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter, our Archonette Club or the Tour Coordinators/Chaperones will not be responsible for lost or stolen items. As such, we strongly advise that you discuss safety and caution with your child and/or student in securing their valuables. PLEASE MAIL COMPLETED APPLICATION AND REQUIRED FORMS TO: Beverly Tatham – 297 Grafton Street, Brooklyn, NY 11212 Please ensure your completed application and required forms/documents are postmarked no later than August 25, 2013 to ensure our timely receipt of same NOTE: YOUR COMPLETED APPLICATION AND REQUIRED FORMS SHOULD NOT INCLUDE PAYMENT WHICH WILL RESULT IN THE RETURN OF YOUR SUBMISSION IN ITS ENTIRETY!!!
Thank you for your support of Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter Archonette Club’s College Tour 2013
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 Registration & Consent Form PLEASE TYPE OR PRINT PART I: All information in this section relates to the student applicant. STUDENT’S NAME:_______________________________________________________________________ (LAST) (FIRST) (MIDDLE) ADDRESS: ______________________________________________________________________________ EMAIL ADDRESS: ________________________________________________________________________ HOME TELEPHONE #: __________________ DATE OF BIRTH (MM/DD/YY): ____________ CELL PHONE #: __________________________________________________________________________ SCHOOL CURRENTLY ATTENDING________________________________________________________ GRADE ______________________ CUMULATIVE GRADE POINT AVERAGE (GPA): _________ PART II – REPORT CARD PLEASE ATTACHED A COPY OF YOUR FINAL REPORT CARD (last or most recent marking period) as well as a PHOTOCOPY OF YOUR CURRENT HIGH SCHOOL ID CARD PART III: FAMILY & EMERGENCY CONTACT INFORMATION PARENT/LEGAL GUARDIAN NAME: __________________________________________ HOME TELEPHONE #: _______________ WORK TELEPHONE #: ___________________ EMERGENCY CONTACT NAME: _____________________________________________ EMERGENCY CONTACT TELEHPONE #: _______________________________________ RELATIONSHIP TO STUDENT: ______________________________________________ PART IV: MEDICAL DISCLOSURE AND INSURANCE INFORMATION (Please use additional sheet if more space is needed) NAME OF HEALTH INSURANCE CARRIER: _____________________________________ POLICYHOLDER NAME: ___________________________________________________ POLICYHOLDER POLICY #: _________________________________________________ PLEASE ATTACH A COPY OF YOUR MEDICAL/HEALTH INSURANCE CARD PLEASE LIST ALL FOOD AND DRUG ALLERGIES: _________________________________ _____________________________________________________________________ _____________________________________________________________________ PLEASE LIST ALL CURRENT MEDICATIONS: ____________________________________ _____________________________________________________________________ _____________________________________________________________________ PLEASE LIST ALL MEDICAL CONDITIONS: ______________________________________ _____________________________________________________________________ _____________________________________________________________________ PLEASE LIST ANY ADDITIONAL VITAL HEALTH REALTED INFORMATION: ______________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
PART V – ROOM-MATE PREFERENCES PREFERRED ROOMMATE #1: ______________________________________________________________ PREFERRED ROOMMATE #2: ______________________________________________________________ PREFERRED ROOMMATE #3: ______________________________________________________________ PREFERRED ROOMMATE #4: ______________________________________________________________ PART VI– PRIOR COLLEGE TOUR EXPERIENCE HAVE YOU PARTICIPATED IN A COLLEGE TOUR BEFORE? Yes____________ No ______________ If so where: _______________________________________________________________________________ HAVE YOU TAKEN THE PSAT? _______________ SAT_________________ ACT ___________________ PART VII - BEHAVIOR POLICY All student participants must adhere and comply with the rules and regulations established by the College Tour Coordinators. There will be a zero tolerance policy for rude, disrespectful or obnoxious behavior including the use of profanity and/or obscenities. The penalty for violation of the behavior policy will be immediate termination of the student’s participation with the College Tour. It will be the student and her parents’ responsibility to make the necessary transportation arrangements for her immediate return home upon notification of her termination by a Tour Coordinator. It is understood that the student and their parent’s signature below indicates their respective agreement to the terms of our behavior and termination policies. PART VIII - DRESS CODE The required dress code for the College Tour will be business casual. This includes, dresses and skirts (of appropriate lengths), dress shirts, blouses (that do not include suggestive or inappropriate messages), dress slacks and comfortable shoes. Jeans and sneakers will not be permitted while we are visiting the college campuses. Students must be appropriately dressed at all other times during the College Tour. STUDENT’S STANDARD OF CONDUCT CONSENT I HEREBY CERTIFY that all statements made herein, and on any attachments are true and correct to the best of my knowledge. Submission of false information may result in non-acceptance on Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter, Archonette Club College Tour 2013. As a condition of my participation in the Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter, Archonette Club College Tour 2013, I agree to abide by the established rules of good conduct and the guidance of the Tour Coordinators/Counselors for students. I also agree that Tour Coordinators/Counselors have the right to enforce appropriate Standards of Conduct and that, at any time during our travel Coordinators have the right to terminate my participation on the Tour for failure to abide by the Tour Standards of Conduct, or for any actions which the Coordinators deem incompatible with the interest, harmony, comfort and welfare of other Tour participants. Should termination occur, I consent to my immediate return to New York City by alternative means at mine and/or my parents’ expense.
Print Student’s Name________________________
SIGNATURE/DATE___________________________
PARENT/LEGAL GUARDIAN RELEASE I HEREBY CERTIFY that I have read the conditions. My signature below indicates that my child has my permission to participate in the College Tour sponsored by Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter (Brooklyn, NY). I understand that this event will include travel outside of New York City and that my child will be under the supervision of the Ladies of Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter. I further consent to the conditions stated above on participation in this event, including the method of transportation. I have instructed my child to follow the rules of conduct as established and directed by the Tour Coordinators/Counselors. I understand that failure
to abide by the rules of conduct and/or serious acts of misbehavior by my child will result in her dismissal from Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter Archonette Club College Tour Group and that I will be responsible for making the necessary travel arrangements for her immediate return to my home. I agree to make full payment of $295 on or before August 17, 2013. NOTE: The amount actually paid may differ depending of method of Paypal payment used – see below. I also understand that my payment is nonrefundable; however, it is transferable to another eligible student. In consideration of my child being allowed to participate in this field trip, I hereby agree on behalf of myself and my child, to release Zeta Phi Beta Sorority, Inc., Zeta Phi Beta Sorority, Inc. Sigma Kappa Zeta Chapter, and its Archonette Club, their employees, agents, and representatives, including volunteers, (collectively “Releases”), from any and all claims including negligence, which may be asserted by my child, or me or on behalf of my child, arising from or relating to my child’s direct or indirect participation in activities conducted under the supervision and directions of Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter and its Archonette Club during the College Tour scheduled for September 4-7, 2013. In the event reasonable attempts to reach me are unsuccessful, I hereby give my consent for medical or dental treatment deemed necessary to be administered to my child. I agree to release to the Tour Coordinators/Counselors from Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter from any and all liability associated with the care and treatment of my child. This release of indemnification does not apply to claims for intentional misconduct or gross negligence; nor does this release of indemnification apply to the extent of commercial insurance coverage for any claim, but this release of indemnification shall apply to the extent of any self-insurance or deductible applicable to any claim. Print Parent/Legal Guardian’s Name__________________________________________________________ SIGNATURE/DATE______________________________________________________________________ Daytime Telephone #: _______________________________Cell #: ________________________________
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 School Consent Form NOTE: This form is required only the 2013-14 school year at your child’s school has begun. Otherwise, please indicate same on the top left corner of this form and return with your submission. To the Principal and Teachers of _________________________________________________________ The members of the Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter would like to thank you in advance for supporting our College Tour. By allowing your students to participate in the tour, you are assisting them in making an informal decision regarding their college choice. Students going on the trip are responsible for making up all missed assignments. While on the trip, the students will have a study period set aside for them. We expect the students to get the work assigned by each teacher completed during this time. Principal: Please sign to show your consent for excused absence for the above named student. _____________________________________________________________ PRINCIPAL OR AUTHORIZED REPRESENTATION SIGNATURE
Date _____________
Classroom Teachers: Please sign below to indicate that you have been informed that this student will be absent from your class to attend the Colleges and Universities Tour. In addition, please indicate if you have given the student assignments to complete while on the College Tour. Period or Mod
Subject
Teacher’s Signature
Assignment Given YES
1 2 3 4 5 6 7 8 9 10
NO
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013
College Tour Checklist All questions must be answered completely and truthfully Submit full non-refundable payment in the amount of $295 on or before 8/17/13. NOTE: The amount actually paid may differ depending of method of Paypal payment used – see below.
Mail completed ZPHIB SKZ College Tour Application including all required forms/documents by 8/25/13 to ensure timely receipt by 8/30/13. PLEASE DO NOT ATTEMPT TO SUBMIT YOUR PAYMENT WITH YOUR FORMS – IT WILL BE RETURNED - EXCEPTIONS! The following forms must be mailed to Beverly Tatham -297 Grafton Street, Brooklyn, NY 11212: o Submit School Consent Form if necessary o Copy of School ID Card o Copy of last year’s final report card o Copy of a valid health insurance card Important dates and details for the College Tour Departure Date & Time: Wednesday, September 4, 2013 @ 7:00PM SHARP Return Date & Time: Saturday, September 7, 2013 @ 8:30PM SHARP Departure & Return Location: Westminster Bethany Presbyterian Church – 644 MacDonough Street (at the corner of Howard Avenue), Brooklyn, NY 11223 Your registration fee is only TRANSFERABLE to another student (provided we receive their completed application and required forms) in the event your child is unable to attend.
FOR FURTHER INFORMATION, PLEASE CONTACT Keisha M. Alleyne, Esq. (917) 687-3143 or Beverly S. Tatham, Esq. (347)623-6361
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 INSTRUCTIONS & FREQUENTLY ASKED QUESTIONS REGARDING USING PAYPAL (Please read the following instructions carefully before making your payment) I.
How Do I make my Payment(s)? A. Visit www.paypal.com B. Select Transfer Option C. Click Send someone money D. You will send your registration fee using our email address at sigmakappazeta@onebox.com
NOTE: Your may send your $295 registration fee WITHOUT incurring the Paypal service charge via your BANK ACCOUNT that is linked to a paypal account OR using your PAYPAL BALANCE (if you already have an account). If you do not have a Paypal account or you do not have your bank account linked to your Paypal account and plan to do to take advantage of the NO FEE payment; please be advised that process takes approximately 3-5 BUSINESS DAYS to complete before you will be permitted to make any payment. Please bear this in mind to ensure your payment by the stated deadline. With that said, you may also send your payment via a DEBIT or CREDIT CARD; however, you will be charged a SMALL FEE (See II below). II.
How Do I calculate the Paypal fee for my DEBIT OR CREDIT CARD payments? A. Paypal charges a fee of 2.9% plus $0.30 of the total amount being sent when the sender (you) uses a debit or credit card.
EXAMPLE: Ms. Tatham wants to pay the registration fee of $295 for her daughter Zahara to attend the 2013 ZPHIB SKZ Archonette Club College Tour using her debit or card card. Ms. Tatham must submit $303.86 (which includes Paypal’s fee) in order to SKZ to receive the full $285 registration fee. The $303.86 is calculated as follows: $295.00 - Registration Fee + $ 8.86 - PAYPAL FEE ($295 x 2.9% + $0.30) = $303.86 – TOTAL AMOUNT TO BE PAID IF USING CREDIT CARD OR DEBIT CARD
. III.
What information MUST be included with my payment(s)? When submitting your payment please ensure that you include the following information in the SUBJECT BOX and MESSAGE TO RECIPIENT BOX: A.
SUBJECT BOX: You got money! for 2013 SKZ Archonette College Tour Registration Fee B. MESSAGE TO RECIPIENT: Insert name of the student for whom payment is being made and parent made. FOR EXAMPLE: This payment is made on behalf of Zahara Tatham (student) by Beverly Tatham (parent)
Zeta Phi Beta Sorority Inc., Sigma Kappa Zeta Chapter Archonette Club (Brooklyn, New York) Wednesday, September 4, 2013-Saturday, September 7, 2013 INSTRUCTIONS & FREQUENTLY ASKED QUESTIONS REGARDING USING PAYPAL (Please read the following instructions carefully before making your payment) IV.
Will I receive a receipt for my payment and how will my payment be officially recorded? Once your payment is successfully completed TWO emails will be automatically generated by the Paypal organizations. There will be an email sent to the email account used to send the payment AND another email will be sent to the chapter's account notifying our Archonette Advisor of your payment.
V.
Is there someone I can contact for additional information or instructions regarding my payment via paypal?
Yes – you may contact Soror Beverly Tatham at 347-623-6361 Monday through Friday between the hours of 7-9pm and on Saturdays between 12noon-6pm.
Thank you for your support of Zeta Phi Beta Sorority, Inc., Sigma Kappa Zeta Chapter Archonette Club’s College Tour 2013