HBCU Tour Application

Historically Black Colleges and Universities (HBCU) Tour Application

DC Pearls III Foundation Working Together With Alpha Kappa Alpha Sorority, Inc., Rho Mu Omega Chapter
Tour Dates:

November 8-13, 2026

Depart & Return location:

Greenway Shopping Center

7589 Greenbelt Road, Greenbelt, MD 20770

Eligibility and Requirements

Students must:

·       currently be enrolled in 10th, 11th or 12th grade
·       complete and submit two (2) copies of the Academic Teacher Recommendation Form
·       submit a completed application packet. Incomplete applications will not be accepted.

Tour Schools:
The 2026 HBCU College Tour will visit the following Colleges and Universities:
- Savannah State University
- Clark Atlanta University
- Spelman College
- Morehouse College
- South Carolina State University
- Claflin University
- North Carolina Central University
- Norfolk State University
- Hampton University
The cost per student for 2026 HBCU College Tour: $600

Cost includes all applicable meals, transportation, lodging and admission to any special events held in association with schools. Payment deadline Friday, October 23, 2026.

Payments can be made online. Payment link will become available upon completion of the application.

Cancellation and Refund Policy:
Requests for cancellation and refunds require a written request and must be received by Friday, October 23, 2026. No cancellations or refunds will be processed after the deadline

HBCU College Tour Mandatory Orientation Meeting:
The mandatory orientation will be held on Wednesday, November 4, 2026 via Zoom

If you have questions, please contact: pmqcollegetour@rhomuomega.org

Parents, please review and sign this application. Your signature indicates that you are aware of your student’s intentions to participate in the 2026 HBCU College Tour. Your signature also indicates that you are aware of the tour fees, and your attendance at the mandatory meeting(s) as stated on this information sheet.

Please note that participation on the 2026 College Tour is contingent upon receipt of all application materials, teacher’s recommendations, payment of all fees, and attendance at mandatory meeting associated with this tour. Please use the checklist included in this packet to assist in submitting a complete application packet.

Please use this checklist to ensure you are submitting a complete Registration Packet.
- Application completed with Parent/Guardian signature
- Two (2) academic teacher recommendation forms
- Copy of student’s school ID
- Medical Information
- Tour Rules—reviewed and signed by parent and student
- All Tour Payments

PERSONAL INFORMATION
Student's Name

First NameLast Name
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Student's Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Name of Parent or Guardian
Is the Address of the Parent/Guardian the Same as the Student
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Email
example@example.com
Relationship to Student
Student T-Shirt Size

Other
SCHOOL INFORMATION
Name of Current High School
School Location (City, State)
Grade
Photo of Student for Identification Purposes

Cancelof
Guidance Counselor's Contact Information
Guidance Counselor's Name

First NameLast Name
Guidance Counselor's Office Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Guidance Counselor's Email
example@example.com
Senior's Information
Are you a High School Senior
Please list the colleges to which you have applied:
What major course of study are you considering?
Have there been any disciplinary actions taken against you in the past two (2)years? Have you ever been suspended from your current or previous schools? If yes, please explain. If none, please enter 'None'
Please list any behavioral conditions that may limit the student’s full participation in this tour (be specific)

MEDICAL HISTORY AND INFORMATION

(Student(s) MUST have medical insurance coverage to participate in the HBCU Tour)
Student Medical Care Authorization

THIS FORM MUST BE COMPLETED BY THE PARENT/GUARDIAN ***STUDENT MUST BRING INSURANCE CARD ON THE TOUR*****
Prescription and Over-the-Counter Medication(s): List the full names of all of the prescription and over-the-counter medications currently being taken by your child. Copy the information from the containers when completing the charts below.
List the names of any allergies. Please include the type of allergic reaction your child will experience.
Please list any food allergies, intolerances, or dietary needs ( e.g., peanuts, gluten, vegan)
General Medical Information

Students should be in possession of only the medication listed on this form while on the tour. All medications must be in original bottles/containers. Chaperones will not be responsible for administering any medication.
Please select the medical conditions applicable to the student:
Other medical conditions not listed above that may limit the student’s full participation in this tour (Please be specific)
List any physical conditions that may limit the student’s full participation in strenuous walking tours (Please be specific)
Emergency Contact Information
Contact #1: Name

First NameLast Name
Contact #1: Relationship to Student
Contact #1: Home Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact #1: Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact #1: Work Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact #2: Name

First NameLast Name
Contact #2: Relationship to Student
Contact #2: Home Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact #2: Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact #2: Work Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Authorization of Medical History
This health history is correct so far as I know, and the person herein described has permission to participate in all prescribed activities, except as noted by me. In the event of illness or accident in the course of such activity, I request measures be instituted without delay as the judgment of medical personnel dictates. Therefore, I grant the program that permission to provide any emergency medical services needed if such is necessary. I understand that this emergency treatment is to be covered by my medical insurance or myself (parent/guardian). It is further understood that my signature grants permission for any hospital to treat my son/daughter as deemed necessary.
Parent/GuardianSignature
Should be Empty:

Historically Black Colleges and Universities (HBCU) Tour Application

PERSONAL INFORMATION

SCHOOL INFORMATION

Guidance Counselor's Contact Information

Senior's Information

MEDICAL HISTORY AND INFORMATION

Student Medical Care Authorization

General Medical Information

Emergency Contact Information

Parent/Guardian Authorization of Medical History